The format for this report was originally developed by the New Jersey Department of Health and Senior Services (DHSS), when it issued the first HMO performance report in 1997 with the cooperation of an advisory group representing HMOs, health care purchasers, providers and consumers. The New Jersey Department of Banking and Insurance (DOBI) assumed responsibility for providing the HMO Performance Report from DHSS in August 2005. All regulatory and oversight matters concerning managed health care in the state are now consolidated in DOBI.
This report includes information on all commercial products currently marketed in New Jersey by HMOs that had at least 2,000 members enrolled in commercial products in both 2006 and 2007. For most HMOs the information combines plan performance for the HMO and POS products. Click here for more information about the distinction between HMO and POS products.
This report does not include HMO performance related to any HMO’s Medicare or Medicaid business or an HMO’s business related to other New Jersey Department of Human Services programs. Click here for ways you can obtain information on these plans.
This report is based on a measurement system called HEDIS®, which was developed by the National Committee for Quality Assurance (NCQA) through the combined efforts of many health care experts. It includes measures collected by the HMOs and measures collected through member surveys. All measures are verified by independent auditors.
This report contains information on the following HMOs and products:
- Aetna-HMO/POS (Aetna Health, Inc.–New Jersey)
- AmeriHealth-HMO/POS (AmeriHealth HMO)
- CIGNA-HMO/POS (CIGNA HealthCare of New Jersey)
- Health Net-HMO/POS (Health Net of New Jersey, Inc.)
- Horizon-HMO (Horizon Healthcare of New Jersey)
- Oxford-HMO/POS (Oxford Health Plans–New Jersey)