MIDDLETOWN, Conn., February 6, 1996 — (NYSE: AET) Aetna Health Plans’ (AHP) health maintenance organizations (HMOs) in Florida, Philadelphia, Cleveland and Atlanta have been granted full accreditation for the next three years from the National Committee for Quality Assurance (NCQA).
Three-year accreditation is the highest NCQA designation. It follows a series of thorough reviews that included interviews with participating AHP network physicians, quality committee members and Aetna’s plan staff.
NCQA reviews health plans against 50 specific standards in the areas of quality management and improvement, credentialing, preventive health services, utilization management, members’ rights and responsibilities, and medical records.
“We’re extremely proud to receive three-year accreditation from the NCQA,” says James W. McLane, AHP’s chief executive officer. “It’s a highly respected, independent confirmation that our HMOs are performing at the highest level in providing quality care and service to our members. It also shows that we’ve made statistically significant improvements in the quality we deliver.”
Aetna Health Plans of Florida covers more than 400,000 members in its HMO, preferred provider organization (PPO), point-of-service and indemnity plans. Its HMO operations experienced tremendous growth in 1995, increasing membership by 78 percent over a one-year period.
Aetna Health Plans of Central and Eastern Pennsylvania covers more than 68,000 members under commercial HMO, Medicare risk and Medicaid contracts.
Aetna Health Plans of Ohio provides benefits to more than 350,000 people in the Cleveland area, and to 1.1 million people across the state. In an independent study released last fall by CareData Reports Inc., AHP was rated No. 1 in overall satisfaction among several HMOs in the greater Cleveland area.
Aetna Health Plans of Georgia, which covers more than 37,000 members, is one of only three HMOs in the state to receive NCQA accreditation.
To date, NCQA has reviewed 209 of the nation’s 574 HMOs, granting three-year accreditation to 73 — or 35 percent — of the plans reviewed. The accreditation process includes rigorous on-site and off-site evaluations, comprehensive interviews, access to quality committee minutes and review of service data.
NCQA is the national organization established to review the quality and medical management systems of HMOs and other managed care plans. Accreditation by NCQA is a nationally recognized standard. The NCQA process evaluates how well a health plan manages all aspects of its medical delivery system and the extent to which it continuously improves health care for its members, in addition to its relationships with medical providers. There is no comparable independent standard for evaluating fee-for-service and other types of health plans.
Aetna Health Plans is one of the country’s leading managed health care companies. In addition to providing health care coverage through HMOs, preferred provider organizations, point-of-service plans and traditional fee-for-service plans, AHP also offers specialty health and group insurance products. In total, AHP products and services reach more than 20 million Americans.
For more information about Aetna Inc., please visit the company’s website at www.aetna.com.