|Next generation of NCQA quality standards measures health plan actions to help members stay healthy, identify and engage those with chronic conditions and help members access care to optimize their health
HARTFORD, Conn., -- Demonstrating its ongoing commitment to providing information and programs to help members access the highest quality health care, Aetna (NYSE: ΑET) has once again volunteered to be measured against a new, consumer-focused set of quality standards being introduced by the National Committee for Quality Assurance (NCQA). The standards will measure Aetna's efforts to promote wellness and prevention, disease management, and complex case management for its members.
NCQA, a private, not-for-profit organization dedicated to improving the quality of health care, yesterday recognized Aetna as an "Early Adopter" of its new Care Management and Health Improvement standards, the second segment of NCQA's new Quality Plus program. As an Early Adopter, Aetna is among the first health plans to agree to be surveyed under the new standards.
"As consumers become more deeply engaged in decision making about their health care, they need tools, information and programs that can help them be effective partners in getting the care they need," said William C. Popik, M.D., Aetna's chief medical officer. "The Quality Plus standards focus on evaluating those tools and activities and we are proud to once again lead the industry in having all 21 of our accredited Aetna health plans measured against them."
Quality Plus is a voluntary, multi-year program that marks a new generation of NCQA health plan assessments and enables health plans to achieve a distinction that supplements their accreditation.
In January, Aetna became the first and only national carrier to be recognized across all its 21 accredited plans as an Early Adopter of Member Connections, the first segment of the Quality Plus standards. Member Connections evaluates the ways in which health plans offer members tools to make educated decisions about their health care.
The Care Management and Health Improvement standards allow NCQA to recognize innovative, market-leading health plans that excel at:
- Providing wellness and prevention tools and resources to keep members healthy
- Identifying and engaging members with chronic care needs
- Coordinating care and access for members with multiple or complex conditions
An important focus of the standards is the health plan's ability to identify members who would benefit from wellness, disease management and case management programs. The standards also look at how effectively the health plan recruits members into relevant programs.
"As we enhance our programs, we are considering the whole member -- and focusing on providing information and resources across the entire spectrum of health care needs. It is important to provide information on wellness and prevention to help members stay well, and equally important to identify and pave the way for improved care for those with more complex needs," said Charles M. Cutler, M.D., national medical director for Quality Management at Aetna. "Meeting the Care Management and Health Improvement criteria demonstrates Aetna's commitment to provide resources that help our members make informed decisions about their health care."
"Plans that meet these standards will show that they go the extra mile to help members prevent and manage chronic illnesses and complex conditions," said Margaret E. O'Kane, NCQA president. "Aetna's commitment to bring all 21 of its plans forward for a survey speaks for itself."
The standards apply to Aetna on a national basis because the activities considered by the standards occur across all accredited Aetna health plans. The next step is to undergo formal evaluation during the Early Adopter review process, expected to take place between October 2005 and March 2006.
Aetna embraces a commitment to quality, as evidenced by the importance placed on achieving NCQA Accreditation. Nationally, of the 21 Aetna plans surveyed by NCQA, all have met NCQA's rigorous standards as of July 2005. Nineteen Aetna HMO and POS plans evaluated by NCQA have received "Excellent" ratings, the highest accreditation rating possible.
As one of the nation's leading providers of health care, dental, pharmacy, group life, disability and long-term care benefits, Aetna puts information and helpful resources to work for its approximately 14.435 million medical members, 12.976 million dental members, 9.117 million pharmacy members and 13.662 million group insurance members to help them make better informed decisions about their health care and protect their finances against health-related risks. Aetna provides easy access to cost-effective health care through a nationwide network of more than 684,000 health care professionals, including over 405,000 primary care and specialist doctors and 4,135 hospitals. For more information, please visit www.aetna.com.
Figures as of June 30, 2005