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Aetna Achieves NCQA Quality Plus Distinction For All Quality Measures


Aetna’s California HMO plan is first in the state to achieve Quality Plus Distinction in all three content areas

Aetna (NYSE: ΑET) announced today that it has been accredited by the National Committee for Quality Assurance (NCQA) with its Quality Plus Distinction in all three content areas: Member Connections; Care Management and Health Improvement; and Physician and Hospital Quality. Aetna Health of California is currently the only HMO in the state that has been accredited by NCQA for meeting or exceeding its rigorous requirements for quality in all three areas.

Quality Plus is a voluntary program for NCQA-Accredited organizations. Aetna’s California HMO plan currently has an Excellent Accreditation rating.

Member Connections standards assess how effectively organizations interact with their members via the Web and telephone to make sure they understand and know how to use their benefits, have access to self-management tools for certain conditions and can check on the status of claims.

Care Management and Health Improvement Standards build on existing chronic care and disease management standards in the MCO Accreditation Program.

Physician and Hospital Quality standards evaluate how health plans measure the quality and cost of care provided by network physicians and hospitals. Purchasers have expressed a strong desire for such information.

“Aetna is to be commended for meeting all of our new Physician and Hospital Quality standards,” said NCQA President Margaret E. O’Kane. “By adopting these standards Aetna is providing members with important information about physicians and hospitals within their network, allowing them to make better health care decisions for themselves and their families.”

Milton Schwarz, M.D., regional medical director for Aetna’s West region, said, “We are pleased to have earned the Quality Plus Distinction from NCQA, which demonstrates Aetna’s commitment to improving health care quality, and to providing members with relevant information to help guide their health care decisions.”

“Aetna has been at the forefront of health care transparency, demonstrated through our own initiatives, and through our collaboration with the California Hospital Assessment and Reporting Taskforce (CHART) and the Integrated Healthcare Association (IHA) Pay for Performance program. This Distinction is another important component of the comprehensive cost and quality information we provide to our members and customers,” Schwarz added.


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