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2007 New Jersey HMO Performance Report
   
Service and Access*


Are members satisfied with their HMO’s services?

A comparison of each HMO’s performance to the New Jersey HMO average shows how effective the HMOs are in providing services to their members.

Higher than average scores mean better performance.

Circles compare each selected HMO's score to the average for New Jersey HMOs. Bar graphs show scores for each HMO on these topics.
Performance Compared to the Average
higher Higher than the New Jersey HMO average
same About the Same as the New Jersey HMO average
lower Lower than the New Jersey HMO average

HMO Rating of
HMO
Getting
needed care
Claims processing Customer
service
Aetna - HMO/POS same same same NA
AmeriHealth - HMO/POS same same same NA
CIGNA - HMO/POS same same same NA
Health Net - HMO/POS higher same same NA
Horizon - HMO lower same same NA
Oxford - HMO/POS same same same NA

*Service and Access is a composite of Rating of HMO, Getting needed care, and Claims processing. NCQA will not be reporting the Customer Service composite for 2007; therefore it is not included in the service and access summary score.
NA – Not available


Due to differences in sample size, HMOs with the same or similar scores can have different circle ratings.

   
 
Rating of HMO
Percent of members who rated their HMO
a 9 or 10 on a scale from 0 (worst possible) to 10 (best possible):
  Getting needed care
Percent of members who reported no problem
getting • a personal doctor they like • to see a specialist • necessary tests or treatment • timely approvals for care:
Rating of HMO   Getting needed care
     
Claims processing
Percent of members who said their HMO alwayshandled their claims • in a reasonable amount of time • correctly:
  Customer service
Percent of members who reported no problem
• finding or understanding written information
• getting needed help from customer service
• completing paperwork:


NCQA will not be reporting the Customer Service composite for 2007; therefore it is not included in the 2007 HMO Performance Report.
Claims processing  
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New Jersey Department of Banking and Insurance