Not all health plans are the same. That's why measuring health care quality is important. Quality information can tell your how well health plans are providing care and services to their members.
The New Jersey Department of Health and Senior Services worked with the National Committee for Quality Assurance (NCQA) to produce this booklet. NCQA ia an independent, not-for-profit organization that assesses, measures and reports on the quality of care provided by the nation's health plans.
There are two sources for the quality information presented in this booklet:
Health Plans. The health plans collected data using a "measuring tool" called HEDIS®. All health plans collected the data in the same way so they can be compared fairly. New Jersey's Department of Health and Senior Services verified the accuracy of the data through an audit. The Peer Review Organization of New Jersey, and independent consultant to the State, audited the data for some plans. Other plans worked with an independent auditor certified by NCQA.
Source: health pan records -- in this booklet, symbol indicates information from the health plan that has been audited to ensure its accuracy.
Consumers. On behalf of the New Jersey Department of Health and Senior Services, the Eagleton Institute's Center for Public Interest Polling at Rutgers University, an independent survey company, conducted a telephone survey of a representative sample of members in each HMO or POS plan. Over 13,000 health plan members were surveyed in 1998. The survey included adult health plan members and parents of children enrolled in the health plan. The survey, Consumer Assessment of Health Plans, was developed by the U.S. Department of Health and Human Services, Agency for Health Care Policy and Research.
Source: consumer survey -- in this booklet, symbol indicates opinions of health plan members who were surveyed.
Note: Look at all factors that make up a health plan's performance and not just results of a particular piece of information. You should not make decisions among health plans based on small percentage differences that may not be meaningful.
Health plan information in this booklet is displayed in two ways:
Charts with circles summarize results and give you the big picture of how the health plans compare. The circles represent how each of the plans performed compared to the group's average (higher, neither higher nor lower or below the average).*
Bar graphs show each health plan's score for most topics.
This report includes only health plans with large commercial enrollments for 1996 and 1997. These plans accounted for 99% of the New Jersey commercial enrollment in 1997.
* Charts with circles show the results of statistical tests between each health plan's score and the average for the NJ health plans shown.
®HEDIS is a registered trademark of NCQA.