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TRENTON
-Acting Health and Senior Services Commissioner George T. DiFerdinando,
Jr. MD, today released New Jersey's fifth annual managed care report
card, which shows the state's HMOs continued to make steady gains
in delivering quality health care.
2001
New Jersey HMO Performance Report: Compare Your Choices
-- which details the performance of 10 health plans that offer HMO
and point-of-service plans -- was released today at a press event
in Trenton.
"New
Jersey continues to be a national leader both in protecting patients'
rights and giving consumers high-quality information about managed
care plans," said acting Governor Donald DiFrancesco. "This
report card will help individual and businesses choose the health
plans that best suit their needs."
"By
shining a spotlight on performance, the report card encourages HMOs
to keep improving their health care quality," said acting Commissioner
DiFerdinando. "I'm pleased with the progress health plans have
made since last year, but we need to do even better. These are standards
every HMO can meet."
Dr.
DiFerdinando noted that New Jersey's State Health Benefits Program
(SHBP) has won a national award for its use of the report card.
The National Healthcare Purchasing Institute gave the SHBP the National
Purchaser of Healthcare Award for providing employees with quality
information about their health plan choices and for using health
plan performance data as part of its contracting standards.
The
report card outlines managed care plan performance both in consumer
satisfaction and in delivering quality health care. The plans are
compared in 20 areas of preventive health care, medical treatment
and customer service.
Since last year, New Jersey plans improved their scores in five
of the nine health measures included in both the 2001 and the 2000
report card. The biggest gain was in the plans' performance in controlling
cholesterol levels in members with heart disease. The percent of
members with controlled cholesterol rose 19 points, from 38 percent
to 57 percent. This is important because reducing cholesterol lowers
the chances of having a heart attack.
Other
gains were seen in the percent of members receiving beta blocker
treatment after a heart attack The 2001 report card showed that
90 percent of members received this treatment, which can help prevent
future heart attacks, compared with 83 percent the prior year.
Cervical
cancer screening rates were up seven points, from 67 percent to
74 percent, and breast cancer screening rates rose four points,
from 65 percent to 69 percent. The percent of members with diabetes
who received an eye exam rose five points, from 38 to 43 percent.
Essentially
unchanged were the percent of people with diabetes who had their
blood sugar tested (71 percent); the percent of new mothers who
received a check-up within eight weeks of delivery (69 percent);
the childhood immunization rate (64 percent); and the percent of
people hospitalized for mental illness who received care afterwards
(68 percent).
This
year's report also contains three new measures that deal with important
chronic health problems -- controlling high blood pressure (43 percent
with blood pressure controlled); children with asthma receiving
appropriate medication (60 percent), and adults with asthma receiving
appropriate medication (60 percent).
The
remaining measures dealt with overall consumer satisfaction, such
as satisfaction with one's doctor, with customer service and with
getting care quickly. The highest score was in the area of getting
needed care, where 74 percent of members reported no problem getting
care.
Despite
the gains in a number of areas, New Jersey continues to lag in regional
and national scores in most measures. New Jersey's cholesterol management
rate does top the national average by four percentage points, and
the state matches the national rate for beta blocker treatment and
asthma medications for children.
"Over
the five years we've been doing this report, we've seen steady performance
gains by the HMOs. As people and businesses continue to use this
report, and as HMOs find ways to improve their health care delivery,
I think we'll see these scores rise," Dr. DiFerdinando said.
The
print version of the report is being mailed to more than 2,000 businesses
in the state. A web-based version of the report card allows consumers
to conduct their research on-line. Consumers can log on at www.state.nj.us/health,
and create and print customized charts comparing the performance
of the plans they're researching.
Both
the web and print version of the report feature a one-page summary
of each plan's overall performance in both customer service and
preventive health care to allow for easier comparisons among plans.
There are also sections on consumer rights, appealing a health plan
decision, choosing a health plan and contacting your health plan.
The
consumer guide includes data for 10 managed health care organizations.
Seven offer both HMO and POS plans: Aetna U.S. Healthcare, AmeriHealth,
CIGNA HealthCare, Oxford Health Plans, Physicians Health Services,
United Healthcare and University Health Plans. Three offer HMOs
only: Horizon Healthcare, One Health Plan and WellChoice HMO.
Information
in the guide comes from two sources. Consumer satisfaction data
comes from a statewide survey of more than 6,000 health plan members.
Performance data on health care delivery comes from measures developed
by the National Committee on Quality Assurance (NCQA), a non-profit
group that assesses managed care quality nationwide. HMOs and POS
plans submitted 2000 data to the department, which were audited
for accuracy.
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 800-418-1397 or by contacting
the Office of Research and Development, 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 hmo@doh.state.nj.us.
There is a fee for multiple copies.
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