This report was prepared by the Department of Health and Senior Services with the assistance of the National Committee for Quality Assurance (NCQA), an independent, not-for-profit organization that assesses and reports on the quality of care provided by managed care organizations nationally. NCQA's web site is www.ncqa.org.

There are two sources for the performance information presented in this report, consumers and health plans.

Consumers

The Eagleton Institute's Center for Public Interest Polling at Rutgers University, an independent survey company, conducted a mail and telephone survey of a representative sample of members in each HMO or POS plan. Over 12,000 health plan members were surveyed for this report. The survey included adult health plan members and parents of children enrolled in the health plan. The satisfaction surveys used Consumer Assessment of Health Plans Study (CAHPS®) were developed by the U.S. Department of Health and Human Services, Agency for Health Care Policy and Research (AHCPR).

Health Plans

The health plans collected data using a "measuring tool" called HEDIS® developed by NCQA. Health plans collected the data in the same way so they can be compared fairly. To verify the accuracy of the HEDIS measures, the plans had to have their data verified by an independent NCQA-Certified auditor.

Technical Notes

Health plans were allowed the option of combining or reporting HEDIS results separately for their HMO and POS products. All the health plans in this report reported combined HMO and POS results when calculating HEDIS measures with the exception of Aetna U.S. Healthcare-New Jersey. The consumer survey, however, was conducted separately for HMO and POS products for health plans in this report.

Performance ratings (circles) indicate the results of statistical tests that compare a plan's score to the average score of all New Jersey plans. Due to differences in standard error that result from different sample sizes and response rates, plans may have the same score (bars), but receive different ratings (circles). For the CAHPS® survey, a plan's score is determined to be "higher" or "lower" than the average score for New Jersey plans if: (a) the difference is statistically significant; and (b) the plan's score differs from the average by at least +/- four percentage points.

Checking on Quality

The State of New Jersey, through the Department of Health and Senior Services, monitors the quality of care and services provided by HMOs and POS plans. The Department investigates consumers' complaints and conducts in-depth reviews of each plan. Plans are also required to obtain a quality audit by an independent review organization every three years.

Take Care of Kids

If you know of a child who is not covered by health insurance, please call (800)701-0710 for information on New Jersey KidCare. Call today to learn about the State's new affordable children's health insurance program.

HEDIS® is a registered trademark of NCQA.
CAHPS® is a registered trademark of AHCPR.