Aetna is a Leader in Pursuing NCQA Accreditation for National PPO Plan.Quality data will inform health care purchaser decisions HARTFORD, Conn. -- Aetna (NYSE NYSE See: New York Stock Exchange :AET AET Aetna, Inc. AET After Extra Time AET Actual Evapotranspiration AET Alliance for Environmental Technology AET Alpha-Ethyltryptamine AET Applied Extrusion Technologies, Inc. ) today announced a significant expansion of its commitment to collecting and providing information that plan sponsors and members can use to evaluate the quality of its health plans. Aetna is pursuing 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' (NCQA NCQA National Committee on Quality Assurance, see there ) Preferred Provider Organization pre·ferred provider organization n. Abbr. PPO A medical insurance plan in which members receive more coverage if they choose health care providers approved by or affiliated with the plan. (PPO PPO abbr. preferred provider organization PPO Managed care Preferred provider organization, see there Infectious disease Pleuropneumonia-like organism, see there ) accreditation at a national level, which means the accreditation will apply to health plan members in all 50 states. Currently, no national PPO plans hold NCQA accreditation. "We recognize the need for consistent and externally validated assessment of the quality of our health plans, and we are eager to provide this information to our plan sponsor customers and our members," said Troyen Brennan, M.D., Aetna Chief Medical Officer. "By showing that we meet or exceed the most rigorous standards of service and care, we enable health plan purchasers to compare our plans against each other and against competing offerings so they can make the choice that best fits their needs. In addition, we can use this data to continuously improve the quality of our health plan offerings." Accreditation for Aetna's national PPO product will complement existing accreditation and performance data on Aetna's 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, and POS (1) See point of sale and packet over SONET. (2) "Parent over shoulder." See digispeak. POS - point of sale products. Aetna anticipates the PPO product review in the third quarter of 2007, with results by the end of the year. This in-depth accreditation process will evaluate Aetna's PPO product as a national entity with consistent national programs and processes. Typically, NCQA's accreditation reviews have been conducted at a state level, and in some cases, at a regional level. "Aetna's choice to bring their PPO forward for NCQA Accreditation is a reflection of their commitment to meeting the toughest standards, being accountable to their members and responding to the demands of employers," said NCQA President Margaret E. O'Kane. "I commend their decision, and look forward to other PPOs following Aetna's lead." During the review, Aetna will present information to NCQA regarding all facets of our health plan operations such as: * Our health plan programs, clinical policies, network accessibility, and member satisfaction. * Ways we help members through clinical programs, pharmacy management, and support and referrals associated with behavioral health Behavioral health was first used in the 1980's to name the combination of the fields mental health and substance abuse. As an example, an organization serving both mental health and substance abuse clients might refer to its practice as behavioral health or issues. * Our network credentialing process, and ongoing quality reviews to help demonstrate our members are receiving high quality, evidence-based care evidence-based care, n a philosophy of treatment that relies on up-to-date, germane research as its foundation. . * Member rights; complaint and appeal handling; physician directories; member and marketing materials; privacy and confidentiality. * And, our full suite of on-line consumer health tools including our Personal Health Record, health risk appraisals, claim and pharmacy information, and other Web-based consumer tools and functionality. "We view this commitment to pursuing NCQA PPO accreditation as reflective of our continuing support for the Executive Order signed by President Bush in August 2006, which called for greater transparency in the health care system to support informed consumer health care decisions and value-based competition in health care," said Charles M. Cutler, M.D., Chief Medical Director, Aetna National Accounts. "Pursuing PPO accreditation joins a robust range of activities Aetna has undertaken to improve visibility into the quality of care our members receive, and the cost of that care." 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 HEDIS Health Plan Employer Data & Information Set Managed care An initiative by the National Committee on Quality Assurance to develop, collect, standardize, and report measures of health plan performances. [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 35.9 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, long-term care long-term care (LTC), n the provision of medical, social, and personal care services on a recurring or continuing basis to persons with chronic physical or mental disorders. and disability plans, and medical management capabilities. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans and government-sponsored plans. www.aetna.com |
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