are pleased to present the sixth 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 what members think about the services they receive.
report is designed to give both 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.
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.
wish you good health and hope this report helps you choose
the health plan that best serves you and your family.
R. Lacy, M.D.
Department of Health and Senior Services
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 2000 and 2001. For most plans the information combines
plan performance for the HMO and POS products. See page 20
for more information about the distinction between HMO and
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.
See page 19 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 experts
in health care. 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
- 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.)
- UHP-HMO (University Health Plans, Inc.)
- WellChoice-HMO (WellChoice HMO of New Jersey)
*Health Net was formerly known as Physicians
Health Services of New Jersey, Inc.
One Health Plan of New Jersey did not comply with requirement
to submit HEDIS measures of performance.
For information on contacting these and other
New Jersey health plans, see page 16.
For additional copies of this report,
please contact the Office of Research and Development, New
Jersey Department of Health and Senior Services, P.O. Box
360, Trenton, New Jersey 08625-0360; telephone (800) 418-1397;
fax (609) 292-6523. 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