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2015 New Jersey HMO and PPO Performance Report
Quality Matters
Why is the quality of health care important?

Not all HMOs and PPOs are the same. HMOs and PPOs differ in how well they keep members healthy and care for them when they become sick. That’s why learning about health care quality is important. 

  • If you are a consumer, the quality of care provided by your HMO or PPO may influence your health and your family’s health.
  • If you are an employer, the quality of care provided by your HMO or PPO may influence absenteeism, employee productivity and your company’s health care cost.

This report provides information about how well HMOs and PPOs:

  • Provided preventive care, such as immunizations and mammograms, to help members stay healthy, and
  • Cared for members who are ill, such as managing the cholesterol level of people with heart conditions.

You can use this report, along with cost and benefit information available from your employer or the HMO or PPO, to choose the right plan for your health care needs.

When choosing an HMO or PPO, you should consider:

  • Whether your doctor or health care provider is available in the HMO’s or PPO's network,
  • Whether the HMO or PPO offers the benefits you want,
  • How much the HMO or PPO will cost you (look at both monthly premiums and out-of-pocket expenses, such as co-payments, coinsurances and deductibles), and
  • How well the HMO or PPO performs in the key areas most important to you.
OPRA is a state law that was enacted to give the public greater access to government records maintained by public agencies in New Jersey.
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New Jersey Department of Banking and Insurance