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September 2002

Dear Consumers:

We 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.

The 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.

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.

We wish you good health and hope this report helps you choose the health plan that best serves you and your family.

James E. McGreevey
Governor

Clifton R. Lacy, M.D.
Commissioner
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 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. 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
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.)
  • 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.

This report is also available on the
Department's web site:

www.state.nj.us/health
or can be requested by e-mail:
hmo@doh.state.nj.us

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.

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