For Further Information Contact: Donna Leusner or Marilyn Riley
New Jersey Releases Sixth Annual Managed Care Report Card New Behavioral Health Care Survey Pilot-Tested
in New Jersey
- Although New Jersey's sixth annual managed care report card shows
HMOs have made modest gains, the state's and the nation's health
care systems still fall short in delivering the highest-quality
health care to help people live longer, healthier lives, Health
and Senior Services Commissioner Clifton R. Lacy, M.D. said today.
Jersey's scores mirror national and regional statistics in most
screening, treatment and medical management measures in the report
card. We must aggressively move to improve our performance in delivering
care that has been scientifically proven to positively impact longevity
and quality of life," Commissioner Lacy said.
fact that this is a national phenomenon suggests that there is no
one simple solution," Dr. Lacy added. "What's needed is
a sustained effort of all our partners in health care to identify
and implement performance improvement strategies to make New Jersey
a national leader in health care and specifically managed care-delivered
next year, the Department of Health and Senior Services will host
a scientific symposium on established best practices in patient
care. The conference, which is being planned in conjunction with
the federal Agency for Healthcare Research and Quality, will be
aimed at health care providers and managed care plans.
Commissioner made his comments today in releasing 2002 New Jersey
HMO Performance Report: Compare Your Choices -- which details
the performance of nine health plans that offer HMO and point-of-service
plans. The department also released the results of the 2001 New
Jersey Experience of Care and Health Outcomes (ECHO) Study,
a survey of consumers' experience with managed care behavioral health
HMO report card outlines managed care plan performance both in consumer
satisfaction and quality health care delivery. The plans are compared
in 20 areas of preventive health care, medical treatment and customer
satisfaction. A one-page summary of each plan's overall performance
allows for easy comparisons among plans.
last year, New Jersey's scores improved in nine of the 11 health
measures included in both the 2002 and 2001 report cards. The average
scores of health plans ranged from a low of 22 percent, for the
percent of people taking medication for depression receiving follow-up
visits, to a high of 90 percent for people receiving beta blocker
treatment after a heart attack. Most measures were in the 60-to-80
biggest gains were seen in areas where the plans' rates were low.
For example, the percent of members with controlled blood pressure
improved from 43 percent in the 2001 report card to 53 percent in
2002. Controlled blood pressure reduces the risk of heart disease,
stroke and renal failure. The percent of diabetics receiving eye
exams increased from 43 to 51 percent. Regular eye exams are needed
to prevent degenerative eye diseases that are a complication of
addition, the percentage of cardiac patients with controlled cholesterol
improved from 57 to 62 percent, children properly immunized by age
two increased from 64 to 70 percent, and the percentage of members
receiving blood sugar testing improved from 71 to 78 percent. The
percentage of new mothers receiving a check-up within eight weeks
of delivery increased from 69 to 73 percent, and cervical cancer
screening rates increased from 74 to 78 percent.
gains were seen in breast cancer screening (69 to 71 percent) and
proper follow-up care for people hospitalized with mental illness
(68 to 70 percent). Essentially unchanged from the 2001 were the
percentage of people receiving beta blocker treatment after a heart
attack (90 percent) and the percentage of children with asthma receiving
appropriate medication for their condition (60 percent). Beta blockers
can help prevent future heart attacks. Proper medical management
of asthma can reduce hospitalization and emergency room visits.
report card's remaining measures deal with overall consumer satisfaction,
such as satisfaction with one's doctor, with customer service and
claims processing, and with getting needed care promptly. The highest
score was in the area of accessing needed care, where 76 percent
of members reported no problem.
"New Jersey continues to be a national leader in protecting
patients' rights and providing high-quality consumer information,"
Commissioner Lacy said. "October and November are generally
open enrollment months for both private and public sector employees.
This report is an excellent tool both consumers and businesses can
use in researching health plans for their families or employees."
in the guide comes from two sources. Performance data on health
care delivery comes from measures developed by the National Committee
on Quality Assurance (NCQA), a non-profit group that assesses managed
care quality nationwide. HMOs and POS plans submitted 2001 performance
data to the department, which were audited for accuracy. Consumer
satisfaction data comes from a 2002 statewide survey of approximately
3,000 health plan members.
consumer satisfaction survey, known as CAHPS (Consumer Assessment
of Health Plans), has been the nationally recognized standard for
assessing consumer experiences with medical care. When development
is completed, the ECHO survey is likely to become the national standard
for reviewing consumer views of behavioral health care services.
was developed by Harvard Medical School and pilot-tested in New
Jersey in 2001 under a grant from the Robert Wood Johnson Foundation.
Behavioral health-care users and non-users were surveyed in the
state's seven largest HMOs. Results were compared with the 2001
CAHPS survey. According to the results, members are satisfied with
the quality of the actual care they receive, whether it's medical
care or behavioral health care counseling. However, behavioral health
care users are less satisfied than medical care users with the managed
care plan itself.
print version of the HMO report is being mailed to more than 2,300
businesses in the state. Through the web-based version, consumers
can log on at www.state.nj.us/health,
and create and print customized charts comparing the performance
of the plans they're researching. An interactive web version of
the report card allows consumers to conduct on-line research of
managed care plans.
State Health Benefits Program, which covers more than 700,000 current
and retired state employees and family members, provides a summary
of the report card results to each member. HMOs that participate
in the SHBP must meet specific standards on the report card's quality
measures or face penalties. The SHBP has been recognized by the
National Health Care Purchasing Institute as a model program for
its using HMO performance data both to inform enrollees and as standards
in contracts with participating managed care organizations.
web-based guide may be viewed, printed or downloaded at no charge.
Copies may be obtained by calling 800-418-1397 or by contacting
the Office of Research and Development, New Jersey Department of
Health and Senior Services, P.O. Box 360, Trenton, 08625-0360. The
guide may also be requested by e-mail at
is a fee for multiple copies.