Aetna Becomes First National Insurer to Receive NCQA Accreditation for PPO Plans: Quality data provide members, employers with credible information
HARTFORD, Conn. (Business Wire EON) December 18, 2007 -- In addition, Aetna also received Full Accreditation for all 12 Medicare Advantage PPO plans that were submitted, which is the most of any health insurer.
"We are extremely proud of this industry-leading acknowledgement from the NCQA. External assessments by credible organizations such as NCQA help employers and members appreciate that Aetna is delivering on its commitment to provide members access to high-quality health care services and programs," said Troyen Brennan, M.D., Aetna chief medical officer.
During the review, Aetna presented information to NCQA about multiple facets of its health plan operations such as:
-- Clinical policies, network accessibility and member satisfaction.
-- Ways we help members through clinical programs, pharmacy management, and support and referrals associated with behavioral health issues.
-- Network credentialing process, and ongoing quality reviews to help demonstrate that members are receiving high-quality, evidence-based care.
-- Member rights, complaint and appeal handling, physician directories, member and marketing materials, privacy and confidentiality.
-- Aetna's full suite of online consumer health tools including the company's Personal Health Record, health risk appraisals, claim and pharmacy information, and other Web-based consumer tools and functionality.
"By receiving Full Accreditation for their PPO products, Aetna has met or exceeded NCQA standards and has excellent programs for quality improvement and consumer protection," said NCQA President Margaret E. O'Kane. "Aetna's accreditation reflects their accountability to their members and their response to the demands of employers."
This accreditation is the latest endorsement that Aetna has received from the NCQA for its products or programs. In 2005 and 2006, the NCQA recognized Aetna for reducing cultural gaps in health care access, and in 2006, Aetna was also the only insurer to receive the prestigious "Recognizing Innovation in Multicultural Health Care Award" from the NCQA. In addition, 21 of Aetna's commercial Health Maintenance Organization/Point of Service (HMO/POS) plans have Excellent Accreditation, NCQA's highest designation for HMO/POS plans.
About NCQA
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA is the nation's leading developer of health care evaluation tools including health plan accreditation, physician recognition and organization certification. NCQA also is responsible for the evolution of HEDIS(R), the most widely used set of health care performance measures. 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 choices. For more information, visit www.ncqa.org.
About Aetna
Aetna is one of the nation's leading diversified health care benefits companies, serving approximately 36.4 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities and health care management services for Medicaid plans. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, government-sponsored plans and expatriates. www.aetna.comAET) announced today that it has received National Committee for Quality Assurance (NCQA) Preferred Provider Organization (PPO) Accreditation at a national level, which means the accreditation will apply to the nearly 10 million Aetna members in PPO plans throughout all 50 states. Aetna is the first national insurer to hold NCQA accreditation for its PPO plans.
In addition, Aetna also received Full Accreditation for all 12 Medicare Advantage PPO plans that were submitted, which is the most of any health insurer.
"We are extremely proud of this industry-leading acknowledgement from the NCQA. External assessments by credible organizations such as NCQA help employers and members appreciate that Aetna is delivering on its commitment to provide members access to high-quality health care services and programs," said Troyen Brennan, M.D., Aetna chief medical officer.
During the review, Aetna presented information to NCQA about multiple facets of its health plan operations such as:
-- Clinical policies, network accessibility and member satisfaction.
-- Ways we help members through clinical programs, pharmacy management, and support and referrals associated with behavioral health issues.
-- Network credentialing process, and ongoing quality reviews to help demonstrate that members are receiving high-quality, evidence-based care.
-- Member rights, complaint and appeal handling, physician directories, member and marketing materials, privacy and confidentiality.
-- Aetna's full suite of online consumer health tools including the company's Personal Health Record, health risk appraisals, claim and pharmacy information, and other Web-based consumer tools and functionality.
"By receiving Full Accreditation for their PPO products, Aetna has met or exceeded NCQA standards and has excellent programs for quality improvement and consumer protection," said NCQA President Margaret E. O'Kane. "Aetna's accreditation reflects their accountability to their members and their response to the demands of employers."
This accreditation is the latest endorsement that Aetna has received from the NCQA for its products or programs. In 2005 and 2006, the NCQA recognized Aetna for reducing cultural gaps in health care access, and in 2006, Aetna was also the only insurer to receive the prestigious "Recognizing Innovation in Multicultural Health Care Award" from the NCQA. In addition, 21 of Aetna's commercial Health Maintenance Organization/Point of Service (HMO/POS) plans have Excellent Accreditation, NCQA's highest designation for HMO/POS plans.
About NCQA
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA is the nation's leading developer of health care evaluation tools including health plan accreditation, physician recognition and organization certification. NCQA also is responsible for the evolution of HEDIS(R), the most widely used set of health care performance measures. 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 choices. For more information, visit www.ncqa.org.
About Aetna
Aetna is one of the nation's leading diversified health care benefits companies, serving approximately 36.4 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities and health care management services for Medicaid plans. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, government-sponsored plans and expatriates. www.aetna.com
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