Aetna Becomes First National Insurer to Receive NCQA Accreditation for PPO Plans: Quality data provide members, employers with credible information
for their health care purchasing decisionsata provide members, employers with credible inf
HARTFORD, Conn. (Business Wire EON) December 18, 2007 --
Aetna (NYSE:AET) 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:
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Clinical policies, network accessibility and member satisfaction.
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Ways we help members through clinical programs, pharmacy management,
and support and referrals associated with behavioral health issues.
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Network credentialing process, and ongoing quality reviews to help
demonstrate that members are receiving high-quality, evidence-based
care.
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Member rights, complaint and appeal handling, physician directories,
member and marketing materials, privacy and confidentiality.
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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®,
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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