Dear Consumers:

We are pleased to present the ninth annual New Jersey HMO Performance Report. This report contains information on the performance of New Jersey’s managed health care plans, how well these plans deliver important health care services, and how members rate the services they receive.

The report is designed to give consumers and employers information on the quality of New Jersey’s managed health care plans. We believe that you will find this information useful when choosing a health plan for your family or business.

New Jersey is a leader in providing comprehensive, strong consumer and patient protections. We urge you to become familiar with these protections, which are explained in this report.

By providing you with this report, we strive to empower you to make the best health care choices for you, your family or your employees.

Richard J. Codey
Acting Governor

Fred M. Jacobs , M.D., J.D
Commissioner
Department of Health and Senior Services


Donal Bryan
Acting Commissioner
Department of Banking and Insurance

The New Jersey Department of Health and Senior Services developed this report with the cooperation of the New Jersey health plans. The Department was guided by an advisory group representing health plans, health care purchasers, providers and consumers.

This report includes information on New Jersey commercial health plans’ health maintenance organization (HMO) and point-of-service (POS) products. The report includes all such health plans currently marketed in New Jersey that had at least 2,000 members in both 2003 and 2004. For most plans the information combines plan performance for the HMO and POS products. Click here for more information about the distinction between HMO and POS products.

This report does not cover the performance of health plans that serve Medicare beneficiaries or beneficiaries of Medicaid and other New Jersey Department of Human Services programs. Click here for ways you can obtain information on these plans.

This report is based on a measurement system called HEDIS®, which was developed by the National Committee for Quality Assurance (NCQA) through the combined efforts of many health care experts. It includes measures collected by the health plans and measures collected through member surveys. All measures are verified by independent auditors.

This report contains information on the following health plans:

• Aetna-HMO/POS (Aetna Health, Inc.-New Jersey)
• AmeriHealth-HMO/POS (AmeriHealth HMO)
• CIGNA-HMO/POS (CIGNA HealthCare of New Jersey)
• Health Net-HMO/POS (Health Net of New Jersey, Inc.)
• Horizon-HMO (Horizon Healthcare of New Jersey)
• Oxford-HMO/POS (Oxford Health Plans-New Jersey)
• United-HMO/POS (UnitedHealthcare of New Jersey, Inc.)
• WellChoice-HMO (WellChoice HMO of New Jersey)*

*WellChoice is also known as Empire HealthChoice.

For information on contacting these and other New Jersey health plans, click here.

For additional copies of this report, please contact the Office of Health Care Quality Assessment, Division of Health Care Quality & Oversight, New Jersey Department of Health and Senior Services, P.O. Box 360, Trenton, New Jersey 08625-0360; telephone (800) 418-1397; fax (609) 530-7478. There is a charge for multiple copies.

Data analysis was provided by the Center for State Health Policy, Rutgers, the State University of New Jersey.
HEDIS® is a registered trademark of the National Committee for Quality Assurance.