UPMC Health Plan Earns Excellent Rating from NCQA
PITTSBURGH (December 12, 2003) UPMC Health Plan has earned the highest accreditation status possible from The National Committee for Quality Assurance (NCQA). The Health Plan received the "excellent" rating the first year it was eligible for a full review by the NCQA.
"To get an 'excellent' accreditation from our first full review is an accomplishment of which the Health Plan is very proud," said Diane Holder, chief executive officer-designate. "It demonstrates our continued commitment to quality and to our growth as a company."
NCQA evaluates health care in three different ways: through accreditation (a rigorous on-site review of key clinical and administrative processes); through the Health Plan Employer Data and Information Set (HEDIS ) 1; and through the Consumer Assessment of Health Plans (CAHPS ) 2, a comprehensive member satisfaction survey. Participation in NCQA is voluntary, but more than half the nation's HMOs currently participate. Approximately 25 percent of the more than 650 HMOs in the country have earned excellent accreditation ratings.
The "excellent" designation is reserved for the best health plans in the nation. It is awarded only to those plans that meet or exceed NCQA's rigorous requirements for consumer protection and quality improvement. HEDIS results, which measure how well a plan delivers clinical care and how satisfied members are with the services of the plan and its provider network, must be in the upper range of national performance in order for a plan to achieve the "excellent" designation.
NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA provides accurate, unbiased information about the nation's managed care organizations and is designed to assist individuals and employers in making informed choices about their health care options.
UPMC Health Plan provides enhanced-access HMO and other health benefits products to more than 400,000 members. Headquartered in Pittsburgh, the Health Plan is a subsidiary of the University of Pittsburgh Medical Center, which has 31 merged and affiliated hospitals throughout western Pennsylvania. UPMC Health Plan members are served by some 6,400 physicians in partnership with over 80 hospitals in 26 western Pennsylvania counties.
1 HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA) 2 CAHPS isa registered trademark of the Agency for Healthcare Research and Quality (AHRQ)