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PO Box 360
Trenton, NJ 08625-0360
|Fred M. Jacobs, M.D., J.D.|
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According to the 2005 New Jersey HMO Performance Report: Compare Your Choices, managed care plans overall improved their scores in seven of 12 areas of preventive health care and medical treatment included in the report card.
“This is care that can lead to better health and quality of life. Every eligible patient should receive this high-quality care, and managed care plans must continue striving for 100 percent on every measure,” Commissioner Jacobs said.
“For consumers, the report is a valuable resource they can use when choosing a health plan for themselves and their families,” he added. “Our online version of the report card even allows you to create customized charts comparing the specific plans you’re considering.”
Eight commercial HMOs and six point-of-service plans are included in the report. In addition to comparing plans in 12 measures of preventive care and treatment, the report includes eight areas of customer satisfaction, such as ability to get care quickly and physicians’ ability to communicate with patients. Plan scores can be compared with statewide averages.
Also included are helpful sections on consumer rights, information on filing appeals and complaints, and advice on choosing a health plan. The report lists contact information for all plans and for other state and federal resources consumers might need.
According to the report card, plans overall scored highest – 96 percent – in giving patients beta blockers after a heart attack. That score was unchanged from 2004. Beta blockers can decrease the risk of heart attack and death. Plans scored lowest – 27 percent – in properly managing people taking antidepressants, although that was an increase of one percentage point over 2004.
Plans made the greatest improvement in the percentage of patients whose high blood pressure is controlled -- up from 59 percent in 2004 to 68 percent in 2005. Other improvements were seen in the percentage of:
The four measures showing declines were: women screened for breast cancer (from 70 to 67 percent); women screened for cervical cancer (80 to 79 percent); children with asthma receiving proper medication (from 73 to 72 percent); and cardiac patients with controlled cholesterol (from 73 to 70 percent). Controlled cholesterol can reduce heart attack risk.
Horizon’s scores went down this year – by more than five percentage points in many cases -- although it remains the only plan with a higher-than-average overall performance in preventive health care and treatment measures. AmeriHealth also declined in many measures, although the declines were smaller.
The HMO report card is one of the Department of Health and Senior Services initiatives to improve health care quality and patient safety. The department also publishes a hospital performance report and a cardiac surgery report. These reports give consumers information they can use to make health care choices, while also encouraging continued quality improvement throughout the health care community. In addition, the department is implementing the Patient Safety Act, which requires health care facilities to confidentially report serious medical errors to the department, and also submit plans to systematically prevent similar errors in the future.
The HMO report is available on the web at http://www.state.nj.us/health/hmo2005. Also available are additional charts showing each plan’s five-year performance on each health measure, as well as state, regional and national score comparisons. Consumers may also view
For those seeking more detailed information, the department publishes The Comprehensive HMO Report on the web. It includes performance data for areas not covered in the consumer report, as well as additional measures on health conditions that are in the consumer version. The 2004 report is now on the web and the 2005 report will be posted in several months.
To obtain copies of the consumer report, call 1-800-418-1397, or contact the Office of Health Care Quality Assessment, Division of Health Care Quality and Oversight, New Jersey Department of Health and Senior Services, P.O. Box 360, Trenton 08625-0360. The guide may be requested by e-mail at firstname.lastname@example.org. There is a fee for multiple copies.
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Department of Health
P. O. Box 360, Trenton, NJ 08625-0360