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Home > Insurance Division > Life and Health > Life & Health Actuarial > HMO Performance Report
2010 New Jersey HMO Performance Report
Getting Better/Living with Illness - 2


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

HMOs should work with doctors to care for members who are sick or living with chronic illness. HMOs reported on the percentage of their relevant membership who received the following:

  • Controlling high blood pressure
  • Cholesterol management (of heart patients)
  • Blood sugar testing for people with diabetes
  • Eye exams for people with diabetes

The following tables show how well each HMO performed and HMO average in New Jersey.

 
HMO Controlling high blood pressure % Cholesterol management of heart patients % Blood sugar testing for people with diabetes %
Eye exams for people with diabetes %
Aetna - HMO/POS 71 58 86 61
AmeriHealth - HMO/POS 66 66 84 47
CIGNA - HMO/POS 64 63 90 57
Horizon - HMO 71 58 88 62
Oxford - HMO/POS 59 55 86 41
 
Controlling high blood pressure
High blood pressure (hypertension) is a major risk factor for a number of diseases. Percent of members aged 18–85 with hypertension whose blood pressure was under control at their most recent medical visit:
  Cholesterol management of heart patients
Reducing cholesterol lowers the chances of having a heart attack. Percentage of members with heart conditions who had their cholesterol level controlled:
Controlling high blood pressure   Cholesterol management of heart patients
     

Blood sugar testing for people with diabetes
Controlling blood sugar levels can prevent complications from diabetes. Percent of members with diabetes who had a blood sugar (HbA1C) test:

 

Eye exams for people with diabetes
Regular eye exams can reduce the risk of blindness from diabetes. Percent of members with diabetes who received an eye exam:

Blood sugar testing for people with diabetes   Eye exams for people with diabetes
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New Jersey Department of Banking and Insurance