Compare Your Choices
NJ Dept. of Health & Senior Services'
Actions to Improve HMO Performance
To improve quality of care in preventive measures . . .
- The department challenged plans to achieve performance
levels by the year 2000 report card that are 5 points higher
than the best scores in last year's report card.
- The New Jersey Association of Health Plans, a trade
organization representing 10 of the largest managed care
organizations in the state, has agreed to sponsor a series
of workshops during the year 2000 that will focus on best
practices to improve performance in preventive measures.
- The workshops will evaluate and recommend improvement
strategies in the areas of pre- and post-natal care, breast
and cervical cancer screening, immunization, mental health
hospitalization follow-up care, diabetes management, and
To improve mental health hospitalization follow-up services. . .
- The department will ask the five HMOs that had
significant performance decreases or were unable to report
data in this area -- Aetna U.S. Healthcare, AmeriHealth,
Horizon, Physicians Health Services and United Healthcare --
to provide the department with an analysis by January 31,
2000, explaining the reduction and outlining their
corrective action plan.
- The analysis, will, in part, look at what functions
have been delegated to mental health contractors and how the
plans monitor these services.
- The plans will also be required to provide quarterly
progress reports and submit updated mental health
performance data in May 2000 so the department can see if
results are improving.
To improve childhood and adolescent immunization rates . . .
- The department will work with managed care plans on a
mailing to share with providers best practices for getting
children and adolescents properly immunized.
- Best practices may include such tactics as giving
quality incentive report cards to providers; giving
providers lists detailing members' immunization status so
they can get children in for shots; and having providers
send reminder cards to members with children who require
- The medical directors of HMOs have pledged that they
will make improving immunization rates a top priority.