Blue Cross and Blue Shield earns one-year NCQA accreditation.BOSTON--(BUSINESS WIRE)--Oct. 2, 1996--Blue Cross and Blue Shield Blue Shield A US not-for-profit health care insurer that is a reimbursement intermediary for physicians. Cf Blue Cross. of Massachusetts (BCBSMA BCBSMA Bluecross Blueshield of Massachusetts ) announced today that it has received 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' (NCQA NCQA National Committee on Quality Assurance, see there ) for its managed care plans, 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, Blue and Blue Choice. "NCQA one-year accreditation is an endorsement and validation of Blue Cross and Blue Shield's managed health care programs and also indicates that they perform well when measured against national standards," said Dr. Kathleen Jennison Goonan, acting chief medical officer. "Quality is at the heart of everything we do and our commitment to that quality takes many forms. We have applied substantial resources to develop programs and services to improve and facilitate the health of our members. Receipt of one-year NCQA accreditation recognizes and validates those efforts." Goonan pointed out that this accreditation status also reinforces other positive ratings that BCBSMA has recently received, including national surveys reported in Newsweek and US News and World Report, and a Spring 1996 independent survey of BCBSMA member satisfaction conducted by ABT ABT About ABT Abteilung (German: Department) ABT Abbott Laboratories (stock symbol) ABT American Ballet Theatre ABT Associação Brasileira de Telemarketing ABT Abort ABT Availability Based Tariff Associates Inc., that showed a three-point improvement from the Fall 1995 measurement. The one-year accreditation is awarded based on strict evaluation strict evaluation - Call-by-value evaluation order is sometimes called "strict evaluation" because, in a sequential system, it makes functions behave as though they were strict, in the sense that evaluation of a function application cannot terminate before evaluation of the of quality and service in six different categories. To evaluate these categories, the survey team used NCQA's 1996 Standards for Accreditation, standards that are considerably more rigorous than accreditation standards in previous years. The categories evaluated were: quality management and improvement; utilization management; provider credentialing; members' rights and responsibilities; preventive health services health services Managed care The benefits covered under a health contract ; and medical records. NCQA conducted this intensive accreditation site visit at BCBSMA from April 8-11, 1996. The two managed care plans receiving accreditation, HMO Blue and Blue Choice, serve a total population of 774,276 members. The service area for these plans covers the entire state and enrollment represents 28 percent of the managed care market in Massachusetts. BCBSMA initiated a formal Quality Improvement Program in 1993 and has made vigorous strides in the program within the last two years. Numerous initiatives, relating to the quality of care, services and health promotion and management have been implemented. "While we are very pleased with this accreditation and view it as official confirmation that we are headed in the right direction, we are committed to sustained improvement over time," said Goonan. "Improvements that, through cooperative efforts with our providers and accounts, will deliver the most effective medical interventions and innovative tools, to provide high quality and effective health and wellness services to all our managed care members." CONTACT: Joe Macrum 617/832-3313 or Susan Leahy 617/832-3488 |
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