Development of this report was guided by the HMO Health Data Committee (HeDaC), an advisory group composed of representatives of the HMO industry, the provider community, health care purchasers and the public. The committee
reviewed the overall strategy for measuring HMO quality and the choice of specific measures. The Department of Health and Senior Services would like to express its appreciation to the committee members for their significant contribution
and commitment to public reporting on HMO quality.
Twelve New Jersey HMOs participated in the consumer survey and ten New Jersey HMOs reported HEDIS statistics. (Refer to page 3 for descriptions of HEDIS and the consumer survey.) The State of New Jersey required HMOs with
2,000 commercial enrollees at the end of 1996 to participate in the consumer survey. The State also required only HMOs with 2,000 enrollees at the end of 1995 to submit HEDIS data. Any measures based on fewer than 100 cases were
excluded from the analysis. Of the eligible HMOs, only NYLCare and First Option failed to produce required HEDIS data necessary to monitor HMO quality.
Most of the information is based on members with commercial coverage who are enrolled in the health plans' HMO. The exception is HEDIS data for AmeriHealth, CIGNA-Southern NJ, CIGNA-Northern NJ and Oxford, which includes members enrolled
in the health plans' point-of-service products. Similar data is being collected for Medicare enrollees by the Health Care Financing Administration and for Medicaid enrollees by the New Jersey Department of Human Services.
The HEDIS measurement system is designed to facilitate comparison of the quality of care provided by different HMOs. However, variation among reported rates could also be due to differences in available data, differences in
data collection methodology or population differences.
For further information from the Department of Health and Senior Services, check our web site: www.state.nj.us/health
