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2009 New Jersey HMO Performance Report
Getting Better/Living with Illness



How well does the HMO care for members who are sick?

A comparison of each HMO’s performance to the New Jersey HMO average shows how effective the HMOs are in working with doctors to care for members who are sick or living with chronic illness.


HMO Management of medicine for depression* Care after hospitalization for mental illness Appropriate medications for asthma (children)
Controlling high blood pressure
Aetna - HMO/POS 68 80 96 71
AmeriHealth - HMO/POS 59 72 93 66
CIGNA - HMO/POS 66 69 94 64
Health Net - HMO/POS 67 82 96 71
Horizon - HMO 66 84 96 71
Oxford - HMO/POS 62 79 95 59

*Antidepressant Medication Management rate is based on Effective Acute Phase Treatment, as Optimal Practitioner Contacts for Medication Management retired this year.
 
Management of medicine for depression
People taking medicine for depression need to be monitored. Percent of members given medicine for depression who had follow-up visits:
  Care after hospitalization for mental illness
Therapy after a hospital stay for mental illness is important for recovery. Percent of members hospitalized for mental illness who received care afterwards:
Management of medicine for depression   Care after hospitalization for mental illness
     
Appropriate medications for asthma (children)
With appropriate therapies, long term control of persistent asthma can be achieved, resulting in a decrease in hospitalizations and emergency room visits for treatment. Percent of pediatric members aged 5–17 with persistent asthma who received an appropriate therapy in the past year:
  Controlling high blood pressure
High blood pressure (hypertension) is a major risk factor for a number of diseases and must be closely monitored and controlled. Percent of members aged 18–85 with hypertension whose blood pressure was under control at their most recent medical visit:
Appropriate medications for asthma (children)   Controlling high blood pressure

 
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New Jersey Department of Banking and Insurance