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ROCKLEDGE, FL (May 16, 2006) — Health First Health Plans (HFHP) announced today it has been awarded an accreditation status of Excellent from the National Committee for Quality Assurance (NCQA), an independent, non-profit organization that assesses and reports on the quality of the nation's managed care plans. Health First Health Plans' accreditation status — the highest possible level — is based on a voluntary review of how a health plan ensures its members are receiving high quality care.
Much of the accreditation is based on results of the Health Plan Employer Data and Information Set (HEDIS®), a tool used by nearly all health plans to measure performance on more than 60 important standards of care and service. Because HEDIS data are collected by such a large portion of the market, and the measures are so specifically defined, HEDIS makes it possible to compare the performance of managed health care plans on an "apples-to-apples" basis. NCQA makes most of the information it collects available online and free of charge to the media and directly to consumers via Healthchoices.org.
"Achieving an accreditation status of Excellent is a significant achievement for a health plan," said Margaret E. O'Kane, president of NCQA. "It is only awarded to those plans that both meet or exceed NCQA's rigorous requirements for consumer protection and quality improvement and have HEDIS results in the highest range of national performance."
The NCQA Accreditation survey process includes on-site and off-site evaluations of over 60 standards and selected HEDIS performance measures conducted by a team of physicians and managed care experts. A committee of physicians analyzes the team's finding and assigns an accreditation level based on the plan's performance in five areas: Access and Service, Qualified Providers Staying Healthy, Getting Better, and Living with Illness.
Some of the ways HFHP meets these standards include verifying credentials of providers to ensure any new physicians joining the network are board-certified, promoting childhood immunizations, surveying members about customer service, enrolling physicians in diabetes education programs, and members can directly access network specialists without a referral.
"We are an organization committed to continuous quality improvement, and I believe that has been validated by NCQA," said Margaret Haney, president of HFHP. "Each of our employees, providers and managers has contributed to the NCQA accreditation process in some way, so we are extremely proud of this achievement."
"This accreditation tells our members that the care they receive and the physicians who provide that care meet or exceed the industry's highest standards of quality," said Joy Eyring, vice president-clinical services for HFHP. "We have a long and proud tradition of providing high-quality care. Receiving objective recognition of that is rewarding for all of us."
More than three-quarters of Americans enrolled in HMOs are in plans that have been reviewed by NCQA and many of the nation's largest companies will not offer their employees a health plan that has not earned NCQA Accreditation. No comparable evaluation exists for fee-for-service health care. And in more than 30 states, health plans that hold NCQA Accreditation are exempted from many or all elements of the annual state audit. Regulators realize that in NCQA-Accredited plans, their quality requirements have already been met or exceeded.
HFHP offers Medicare Advantage Prescription drug plans to individuals, a variety of commercial/group plans to local employers, including HMO, POS, and high-deductible options, as well as third-party administration services. HFHP currently has 73,000 members, including 21,000 Medicare members — nearly one out of every seven residents in Brevard.
Serving residents of Brevard County and part of Sebastian in Indian River County for 10 years, HFHP was founded as part of Health First, a not-for-profit family of healthcare services that also includes Cape Canaveral Hospital, Holmes Regional Medical Center, Palm Bay Community Hospital, Health First Physicians. For more information, visit healthfirsthealthplans.org or call 321.434.5600.
HEDIS® is a registered trademark of NCQA
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