Trenton, NJ 08625-0360
October 11, 2000
EDISON - Governor Christie Whitman and Health and Senior Services Commissioner Christine Grant today released New Jersey's fourth annual managed care report card, which this year helps consumers and employers more quickly compare the performance of HMOs and point-of-service plans.
2000 New Jersey HMO Performance Report: Compare Your Choices was released today at a press event at PSEG in Edison. The earlier release of this year's report will make it more useful to employees of large corporations, who choose their health plans in October and November.
"New Jersey has been a national leader in protecting managed care consumers and helping them choose their health plans," said Governor Whitman. "In this year's report, employers and individuals will find even more information and new features that can speed their research."
The New Jersey Department of Health and Senior Services is mailing the report to more than 2,000 businesses in the state.
The consumer guide includes information on how well managed care plans are delivering quality health care and customer service. The state's 10 largest commercial HMOs and point of service plans operated by the HMOs are compared in 20 areas of preventive health care and customer service.
Overall, New Jersey's managed care plans continued to make modest improvement in health care delivery. However, progress was uneven, Commissioner Grant noted.
Scores did rebound dramatically in one area over the previous year - providing after-care services for members who have been hospitalized for mental illness. Cervical cancer screening also increased, while breast cancer screening rates and eye exams for people with diabetes declined slightly.
"These screenings and checkups are at the core of good health care. These are standards every HMO can meet," the Commissioner said.
Changes in this year's report card make it even easier for consumers to compare plans. Consumers can log on to the web-based report card which, for the first time, lets them conduct on-line comparisons of the plans. They can create and print customized charts comparing the performance of plans they're researching to each other and to state averages.
Both the web and print version of the report also feature a new, one-page summary of each plan's overall performance in both customer service and preventive health care. This allows for easier, at-a-glance comparisons among plans. And this year's report contains expanded sections on consumer rights, and advice on how to choose a health plan and navigate the health care system.
Consumers with medical conditions also will find helpful data on plan performance in three new areas - blood sugar testing for people with diabetes, controlling cholesterol levels in people with heart disease, and monitoring of depression medication.
"We encourage our employees to review the HMO report card when selecting their health plan," said Richard Quinn, director of performance and rewards at PSEG, who added that the report card is available on the company's employee benefits web site. "The HMO report card is also one of the research tools we use in evaluating those plans we make available to our employees."
Last year, the Commissioner required six plans to take steps to correct their poor performance in providing follow-up care for people who had been hospitalized for mental health problems. Last year's report card showed that only 51 percent of patients got the needed care within a month of discharge. In this year's report card, which reflects 1999 data, the rate is up to 69 percent. Preliminary data this year shows HMOs continue to improve on this measure.
The Commissioner noted that, despite some improvements, New Jersey's plans continue to lag national and regional scores in most areas. The department will continue to work with the New Jersey Association of Health Plans, a trade group representing the state's largest HMOs, to overcome barriers to improvement in specific health measures.
Since last year, the association has held a round table for plans on the best methods to improve breast and cervical cancer screening rates. Round tables in other health care areas will be held in the future. The plans are also working to improve childhood and adolescent immunization rates. HMOs are part of the Newark Immunization Initiative as well as the department's statewide advisory group on immunization.
The consumer guide includes data for 10 managed health care organizations, all but one offering both HMO and POS plans in the state. The plans are: Aetna U.S. Healthcare, AmeriHealth, AtlantiCare Health Plans, CIGNA HealthCare, Horizon Healthcare (HMO only), Oxford Health Plans, Physicians Health Services, Prudential HealthCare, United Healthcare, and University Health Plans.
Information in the guide comes from two sources. Performance data on health care delivery comes from a set of measures developed by the National Committee on Quality Assurance (NCQA), a non-profit group that assesses the quality of care provided by HMOs nationwide. HMOs and POS plans submitted 1999 data to the department, which were audited for accuracy.
Consumer satisfaction data comes from a statewide survey of 5,000 health plan members conducted by the plans and reported to NCQA as part of its nationwide data collection system. Plans used the Consumer Assessment of Health Plans Study, the same survey the department used in conducting the survey for previous report cards.
The guide is available on the department's web site at www.state.nj.us/health and may be viewed, printed or downloaded at no charge. Copies of the guide may be obtained by calling 1-888-393-1062, or writing the Office of Managed Care, New Jersey Department of Health and Senior Services, P.O. Box 360, Trenton, 08625-0360. The guide may also be requested by e-mail at email@example.com. There is a fee for multiple copies.