Updated How do N.J.’s health plans rate? National survey has the answer

Jessica Perry//September 25, 2014

Updated How do N.J.’s health plans rate? National survey has the answer

Jessica Perry//September 25, 2014

(Editor’s note: This story was updated at 4:20 p.m. Friday with comments from Judith L. Roman of AmeriHealth NJ.) A national report card of how health insurers stack up when it comes to achieving best-practices benchmarks for preventive care, medical treatment and consumer satisfaction has been released by the National Committee for Quality…The full report is at ncqa.org.

Among New Jersey plans, Cigna got an overall score of 83 out of possible 100, the highest score for a health plan operating in New Jersey. The NCQA report covers a total of 617 health plans, broken out by state and type of health plan.

Among the New Jersey scores:

  • Aetna, 82.1;
  • Horizon Blue Cross Blue Shield of New Jersey, 82;
  • AmeriHealth New Jersey, 81.1;
  • The Oxford unit of UnitedHealthcare, 80.4

NCQA is a nonprofit organization dedicated to improving health care quality. It recognizes physicians and medical practices that have reached certain quality benchmarks by awarding them the NCQA “patient centered medical home” designation.

Scott Evelyn, president and general manager for Cigna in New Jersey, said, “The rankings enable us to better understand the needs of our customers, because they provide insights into areas where we perform well and areas where we can improve further.

 “Together with local health care systems and professionals, Cigna works to provide our customers with access to quality care and services,” he added, “and we are pleased that this year’s NCQA rankings reflect our efforts.”

While Cigna’s score of 83 for two of its New Jersey plans was the highest score in New Jersey, nationally, those plans ranked 119th. NCQA’s highest-scoring plan nationally is the Tufts Associated HMO, serving Massachusetts and Rhode Island, with a score of 90.4.

“We review the annual NCQA rankings each year to find opportunities to improve the consumer health care experience,” Aetna spokeswoman Susan Millerick said. “Traditionally, integrated health systems have fared best, and we believe our collaborative work with some of New Jersey’s largest providers, developing medical homes, accountable care and other new arrangements, will continue to improve these scores and, more importantly, to improve health care quality and patient satisfaction.”

Horizon spokesman Tom Vincz said his company “is committed to improving the quality of health care for all our members,” which is why it “is building the largest network of patient-centered practices focused on the quality, not quantity, of patient care. We won’t be satisfied until we’re No. 1 in the NCQA rankings.”

AmeriHealth NJ Chief Executive Judith L. Roman said: “With the health care industry undergoing so much change, meeting best practices benchmarks and understanding how we are impacting our members has never been more important. Our goal is to enable the people of New Jersey to improve their health and well-being while helping them gain access to affordable, quality care. We are pleased to be playing a role in helping transform the delivery of care in the state.”

UnitedHealthcare spokeswoman Mary Mcelrath-Jones said: “The NCQA rankings continue to reflect the ongoing quality improvements and investments we’ve made in our health plans. From national initiatives that promote healthy habits and targeted programs that serve local communities, to customized services for people with complex conditions, UnitedHealthcare is making the health care experience more personal, accessible and affordable for those we serve.”

She said UnitedHealthcare has launched programs to “engage and empower people to become more active participants in their own health, and by collaborating with physicians and other health care professionals to close gaps in care.”


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