Aetna Health Plans of California Inc.-San Diego receives one year NCQA accreditation.WALNUT CREEK Walnut Creek, residential city (1990 pop. 60,569), Contra Costa co., W Calif., in the San Francisco Bay area; inc. 1914. It is the trade and shipping center of an extensive agricultural area where walnuts are among the major product. , Calif.--(BW HealthWire)--June 12, 1997--Aetna Health Plans of California Inc.'s San Diego San Diego (săn dēā`gō), city (1990 pop. 1,110,549), seat of San Diego co., S Calif., on San Diego Bay; inc. 1850. San Diego includes the unincorporated communities of La Jolla and Spring Valley. Coronado is across the bay. health maintenance organization (HMO HMO health maintenance organization. HMO n. A corporation that is financed by insurance premiums and has member physicians and professional staff who provide curative and preventive medicine within certain financial, ), owned and operated by Aetna U.S. Healthcare U.S. Healthcare is a now-defunct healthcare company. The logo had an apple. The merger with Aetna In 1996, the company merged with Aetna, calling it Aetna U.S. Healthcare. The U.S. Healthcare apple logo was next to the Aetna name, and U.S. Healthcare under it. U.S. , has been granted one-year accreditation from the National Committee for Quality Assurance National Committee for Quality Assurance Medical practice A private, not-for-profit organization which has become the leading accreditor of managed care plans; in site visits, NCQA reviewers evaluate a managed care plan in terms of quality management, physicians' . The National Committee for Quality Assurance (NCQA NCQA National Committee on Quality Assurance, see there ) is an independent, not-for-profit organization that evaluates managed care plans. NCQA reviews health plans against 50 specific standards in the areas of quality management and improvement, physician credentialing Credentialing is the administrative process for validating the qualifications of licensed professionals, organizational members or organizations, and assessing their background and legitimacy. , preventive health services health services Managed care The benefits covered under a health contract , utilization management Utilization management is the evaluation of the appropriateness, medical need and efficiency of health care services procedures and facilities according to established criteria or guidelines and under the provisions of an applicable health benefits plan. , members' rights and responsibilities, and medical records. "We are proud that our commitment to improve the health of our members through quality improvement programs has been recognized by NCQA," said Dr. Howard Arkans, western region medical director for Aetna U.S. Healthcare. Aetna Health Plans of California Inc.'s San Diego HMO provides access to health care services for 61,000 members. "We are happy to receive this level of accreditation from NCQA," said Dean Hosmer, general manager for Aetna U.S. Healthcare's operations in San Diego. "Together, with our participating physicians and hospitals we have worked hard to provide access to quality clinical care and service for our members." The accreditation process includes rigorous on-site and off-site evaluations conducted by teams of physicians and managed care experts, comprehensive interviews, access to quality committee minutes and review of clinical and service data. Aetna Health Plans of California Inc. is one of 17 health plans to have an NCQA accreditation status throughout all of California, as of April 30, 1997. Hosmer commented, "San Diego now joins the rest of our California service area in having some level of NCQA accreditation. It is important to receive this confirmation that our quality and prevention programs are succeeding in improving the overall health care for our members." 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. In California, Aetna Health Plans of California Inc. provides health coverage to more than 445,000 members through its HMO. Aetna U.S. Healthcare is one of the country's leading managed health care companies. In addition to providing health care coverage through HMOs, PPOs, point-of-service and traditional plans, Aetna U.S. Healthcare also offers specialty health and group insurance products. CONTACT: Aetna U.S. Healthcare, Walnut Creek Bobby Pena, 510/941-2826 |
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