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UPMC for You Earns Top 10 Rating Nationally for Medicaid Health Plans

PITTSBURGH (December 16, 2004) UPMC for You, the Medicaid program for UPMC Health Plan, is one of the nation's 10 highest-rated Medicaid health plans for effectiveness of care, according to a report released today by the National Committee for Quality Assurance (NCQA).

This is the first year that NCQA, an independent, not-for-profit organization that evaluates managed care organizations, has rated Medicaid health plans. Only health plans that have NCQA accreditation of "Excellent" were eligible to be rated.

UPMC for You was the only Medicaid health plan in Pennsylvania to be rated in NCQA's top 10.

"We are honored to see UPMC for You recognized as a `Top 10' Medicaid Health Plan," said Diane P. Holder, president of UPMC Health Plan. "This really reflects our ongoing commitment to our Medicaid population. It also is a reflection of the hard work and dedication on the part of our doctors, nurses, hospitals, case management workers, and all other health care providers.

"It's not just the numbers that are important. It's what you do to earn those numbers. At UPMC for You, we help people get to where they need to go to get care in a timely manner."

UPMC for You was rated in the 90th percentile in nine effectiveness-of-care categories. These include childhood immunization, adolescent immunization, breast cancer screening, smoking cessation, prenatal and postpartum care, and comprehensive diabetes care.

The top plans were determined by Health Plan Employer Data Information Set (HEDIS) Effectiveness of Care measures. HEDIS is a set of standardized performance measures designed to ensure that purchasers and consumers have the information they need to reliably compare the performance of managed health care plans.

In compiling its findings, NCQA reviewed HEDIS data from over 100 Medicaid plans, covering over 50 million lives. HEDIS is a registered trademark of NCQA.

UPMC Health Plan was founded as Best Health Care of Western Pennsylvania, a Medicaid HMO, in 1996. Best Health Care was renamed UPMC for You in January 2003.

UPMC Health Plan, a subsidiary of the University of Pittsburgh Medical Center (UPMC), serves more than 440,000 members with its Medicaid, Medicare and commercial insurance products. More than 90,000 Medicaid members are served by UPMC for You.

Earlier this year, UPMC Health Plan was recognized by the NCQA in a report titled, "The State of Health Care Quality: 2004." UPMC Health Plan was the only western Pennsylvania insurer to earn a top-five rating in the Middle Atlantic region, which comprises Pennsylvania, New Jersey and New York. NCQA also reported that UPMC Health Plan had the top HEDIS score in the nation for breast cancer screening.

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