We are pleased to present the fourth annual New Jersey HMO Performance Report. This report card looks at the performance of New Jersey's managed health care plans, how well these plans deliver important health care services and what members think about the services they receive. This year we added the following new measures: claims processing, cholesterol management, management of medicine for depression and blood sugar testing for people with diabetes.
The report is designed to give both consumers and employers information about the quality of New Jersey's managed health care plans. We hope that you will use this information in choosing a health plan for your family or business.
Remember that New Jersey has some of the strongest consumer and patient protections in the country. We urge you to become familiar with these protections, which are explained in this report.
We wish you good health and hope this report helps you choose the best health plan for you and your family.
Christine Todd Whitman, Governor
Christine Grant, Commissioner
The New Jersey Department of Health and Senior Services developed this report with the cooperation of the New Jersey health plans. The Department was guided by an advisory group representing health plans, health care purchasers, providers and consumers.
This report includes health maintenance organizations (HMOs) and point of service (POS) plans in New Jersey that enrolled at least 2,000 commercial members in 1998 and 1999. These health plans cover 99 percent of the State's commercial enrollment. For most plans, the information combines a plan's performance for their HMO and POS products. However, for AtlantiCare Health Plans and Horizon Healthcare of New Jersey, Inc., the POS products are not included. This report does not cover the performance of health plans that serve Medicare or Medicaid beneficiaries. See Other Important Resources for ways to get information on Medicare and Medicaid plans. See HMO and POS Plan Differences for the distinctions between HMOs and POS plans.
This report is based on a measurement system, HEDIS®, which includes both measures collected by the plans and a consumer survey. All measures were verified by independent auditors.
This report contains information on the following health plans:
- Aetna U.S. Healthcare-New Jersey (Aetna USHC-HMO/POS)
- AmeriHealth, Inc. (AmeriHealth-HMO/POS)
- AtlantiCare Health Plans (AtlantiCare-HMO)
- CIGNA HealthCare of New Jersey, Inc. (CIGNA-HMO/POS)
- Horizon Healthcare of New Jersey, Inc. (Horizon-HMO)
- Oxford Health Plans-New Jersey, Inc. (Oxford-HMO/POS)
- Physicians Health Services of New Jersey, Inc. (PHS-HMO/POS)
- Prudential HealthCare-New Jersey (Prudential-HMO/POS)*
- UnitedHealthcare of New Jersey, Inc. (United-HMO/POS)
- University Health Plans, Inc. (University-HMO/POS)
* Aetna U.S. Healthcare purchased Prudential HealthCare in 1999.
For copies of this report, please contact the Office of Managed Care, Department of Health and Senior Services, P.O. Box 360, Trenton, New Jersey 08625-0360, phone (888) 393-1062, fax (609) 633-0807. There is a charge for multiple copies. This report can be requested by e-mail: email@example.com.
This document may only be reproduced in its entirety. No portion of this document may be reproduced without the permission of the New Jersey Department of Health and Senior Services.
© 2000 New Jersey Department of Health and Senior Services