樱花视频

October 2013

Dear Consumers:

We are pleased to present the seventeenth annual 樱花视频 HMO Performance Report. This report contains information on the performance of 樱花视频’s health maintenance organizations (HMOs), and how well these HMOs deliver important health care services.

The report is designed to provide information to consumers and employers on the quality of 樱花视频's HMOs and the available coverage. We believe that you will find this information useful when choosing health coverage for your family or business.

樱花视频 is a leader in providing comprehensive, strong consumer and patient protections. We urge you to become familiar with these protections, which are explained in this report.

By providing you with this report, we strive to empower you to make the best health care choices for you, your family or your employees.

Chris Christie
Governor

Kenneth E. Kobylowski
Commissioner
Department of Banking and Insurance

The format for this report was originally developed by the 樱花视频 Department of Health, when it issued the first HMO performance report in 1997 with the cooperation of an advisory group representing HMOs, health care purchasers, providers and consumers. The New Jersey Department of Banking and Insurance (DOBI) assumed responsibility for providing the HMO Performance Report from the 樱花视频 Department of Health in August 2005. All regulatory and oversight matters concerning managed health care in the state are now consolidated in DOBI.

This report includes information on all commercial products currently marketed in 樱花视频 by HMOs that had at least 2,000 members enrolled in commercial products in both 2011 and 2012. For most HMOs the information combines plan performance for the HMO and POS products.

The following HMOs and products are included in this report:

• Aetna-HMO/POS (Aetna Health Inc. – a 樱花视频 Corporation)
• AmeriHealth-HMO/POS (AmeriHealth HMO, Inc. – 樱花视频)
• CIGNA-HMO/POS (CIGNA HealthCare of New Jersey, Inc.)
• Horizon-HMO (Horizon Healthcare of 樱花视频, Inc.)
• Oxford-HMO/POS (Oxford Health Plans of 樱花视频)

This report does not include HMO performance related to any HMO’s Medicare or Medicaid business or an HMO’s business related to other 樱花视频 Department of Human Services programs. (See Other Important Resources for ways you can obtain information on these programs.)

This report is based on a measurement system called HEDIS®, which was developed by the National Committee for Quality Assurance (NCQA) through the combined efforts of many health care experts. It includes measures collected by the HMOs and measures collected through member surveys. All measures are verified by independent auditors.

In prior reports, we included ratings of member satisfaction with HMO services. Now you can find summary measures of customer satisfaction by visiting the NCQA's web site. (See Choosing Your HMO for more information.)

For information on contacting these and other 樱花视频 HMOs, see Contacting Your HMO

HEDIS® is a registered trademark of the National Committee for Quality Assurance.