Aetna Earns Physician Quality Certification from National Committee for Quality Assurance
February 22 2012 - 9:39AM
Business Wire
Aetna (NYSE: AET) announced today that its Aexcel® program, a
designation for physician specialists in its Physician Performance
Network, received Physician Quality Certification from the National
Committee for Quality Assurance (NCQA). Aetna’s Physician
Performance Network is made up of health care specialists across
the country who meet nationally recognized standards for clinical
performance, as well as Aetna’s efficiency standards. The
certification applies to all 40 markets where the program is
currently available, and is effective through December 2013.
The NCQA Physician Quality Certification program evaluates how
well health plans measure and report the cost and quality of
physicians, and is the first program to independently assess health
care provider measurement programs.
“We have worked diligently to ensure our physician performance
measurements are meaningful and created with a transparent and
collaborative approach,” said Andrew Baskin, MD, head of Aetna’s
Medical Quality and Provider Performance Measurement area. “We are
proud to have earned NCQA’s Physician Quality Certification, which
validates our commitment to providing members with reliable
information they can use to make educated choices on their health
care.”
“By earning PHQ Certification, Aetna has shown its commitment to
quality includes transparent, rigorous review of the physicians and
hospitals with whom it works,” said Margaret E. O’Kane, NCQA
President. “That measurement, transparency and collaboration
between organizations are cornerstones of better care.”
Helping Members Understand the Quality and Cost of
Care
Specialists with Aexcel designation are identified with a blue
star in Aetna’s online provider directory, DocFind®, making it easy
for members to find them. Providing members with easily accessible
information on these high performance health care providers
demonstrates Aetna’s commitment to the Patient Charter for
Physician Performance Measurement, Reporting and Tiering Programs,
which Aetna has supported since 2008.
Aetna provides a number of additional resources to help members
better understand the quality and cost of the health care services
they receive. One popular tool for Aetna members is the Member
Payment Estimator, with more than 67,000 hits per month in 2011.
The Member Payment Estimator provides real-time cost estimates for
in-network and out-of-network care for more than 500 commonly used,
non-emergency health care services. This level of detail – a first
for health plan members – gives members a more complete picture of
the costs involved and helps people better plan for and budget for
health care. Members can also use the Member Payment Estimator to
see if a physician has been designated as an Aexcel specialist.
The U.S. Government Accountability Office recently released
a report regarding the transparency of health care costs,
and the Member Payment Estimator was recognized as the only tool
from a private health insurance company that “provides estimates of
a consumer’s complete cost.” Additional information on the Member
Payment Estimator is available on the Aetna website, or
through a case study from Forrester Research.
About NCQA
NCQA is a private, non-profit organization dedicated to
improving health care quality. NCQA accredits and certifies a wide
range of health care organizations. It also recognizes clinicians
and practices in key areas of performance. NCQA is committed to
providing health care quality information for consumers,
purchasers, health care providers and researchers.
For more information about NCQA please visit www.ncqa.org.
About Aetna
Aetna is one of the nation's leading diversified health care
benefits companies, serving approximately 36.4 million people with
information and resources to help them make better informed
decisions about their health care. Aetna offers a broad range of
traditional, voluntary and consumer-directed health insurance
products and related services, including medical, pharmacy, dental,
behavioral health, group life and disability plans, and medical
management capabilities and health care management services for
Medicaid plans. Our customers include employer groups, individuals,
college students, part-time and hourly workers, health plans,
health care providers, governmental units, government-sponsored
plans, labor groups and expatriates. For more information, see
www.aetna.com.
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