October 17, 2005

NCQA Highlights Plans that Excel at Providing Patients with Information About Their Care

21 Aetna plans are first to meet new standards; requirements emphasize access to claims, pharmacy data, online health tools

WASHINGTON— The National Committee for Quality Assurance (NCQA) today announced that 21 health plans, all of which are Aetna plans [see attached list], are the first to earn distinction under its new Member Connections standards. The voluntary Member Connections standards focus on how effectively plans communicate with members to engage them in key decisions about their care. Reports on each plan that has met the new standards are available online through NCQA’s Health Plan Report Card.

“Technology today makes it possible for plans to connect with members and keep them involved in their care,” said NCQA President Margaret E. O’Kane. “There’s real value to keeping patients informed and involved—engaged patients have better outcomes. Aetna is to be commended for making a real investment in this area and for meeting our new Member Connections standards.”

Member Connections standards assess how effectively an organization interacts with its members via the Web and telephone to help them understand benefits, access self-management tools for certain conditions, look up drug information and check the status of their claims. While the new standards are voluntary, NCQA expects to eventually incorporate them into its core accreditation programs.

“Aetna is proud to provide tools and information that make it easy for consumers to interact with us, as well as with the health care system,” said Charles M. Cutler, M.D., M.S., Aetna’s Chief Medical Officer. “We welcome NCQA’s assessment and public reporting on the quality of these tools and services, and hope consumers will continue to find them helpful in making informed, confident decisions about their health care.”

Visitors to NCQA’s Web site can drill down from the Health Plan Report Card to view additional information about the Member Connections standards plans are required to meet in six areas:

• Health Risk Appraisals
• Health Tools
• Claims Processing
• Pharmacy Benefits
• Personalized Services
• Innovative Member Services

Nearly 40 health plans signed up for surveys under NCQA’s Member Connections standards when they were unveiled in January. Many of those surveys are scheduled to take place over the next few months. NCQA will update its Web site on a monthly basis to feature plans that meet its Member Connections standards in the future.

NCQA is an independent, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and offers recognition programs for physicians and physician groups. NCQA is committed to providing health care quality information through the Web, media and data licensing agreements in order to help consumers, employers and others make more informed health care choices.

Plans meeting Member Connections standards
 
Aetna – Arizona 
Aetna – Colorado 
Aetna – Connecticut 
Aetna – Delaware 
Aetna – Florida 
Aetna – Georgia 
Aetna – Maine 
Aetna – Maryland, DC, and Virginia 
Aetna – Massachusetts 
Aetna – Missouri 
Aetna – New York 
Aetna – Northern New Jersey 
Aetna – Ohio
Aetna – Oklahoma 
Aetna – Pennsylvania 
Aetna – Southern New Jersey 
Aetna – Tennessee 
Aetna – Texas 
Aetna of California 
Aetna of Illinois
Aetna of the Carolinas