Wednesday, October 10, 2018
PITTSBURGH (Oct. 10, 2018) — Highmark Choice Company (HCC), Highmark's health maintenance organization (HMO) in western Pennsylvania, has achieved national recognition for quality as the plan was recently awarded "Excellent" Accreditation status by the National Committee for Quality Assurance (NCQA).
In NCQA's Private Health Insurance Plan Ratings 2018–2019, several Highmark companies received high ratings, including: HCC, which is in the 50 highest-rated Commercial health plans in the nation, and in the five top-rated Commercial health plans in Pennsylvania; Highmark Blue Cross Blue Shield Delaware, which is the top-rated private plan in the state of Delaware; and Highmark West Virginia, which is the top-rated PPO in West Virginia.
NCQA Health Plan Accreditation evaluates how well a health plan manages all parts of its delivery system — physicians, hospitals, other providers, and administrative services — in order to continuously improve the quality of care and services provided to its members.
The NCQA has awarded its highest accreditation status of Excellent for service and clinical quality that meet or exceed NCQA's rigorous requirements for consumer protection and quality improvement. Healthcare Effectiveness Data and Information Set (HEDIS®) and Consumer Assessment of Healthcare Providers and Systems (CAHPS®) results are in the highest range of national performance.
"Earning Excellent Accreditation reflects a health plan's ability to work with its members' physicians to improve the quality of clinical care. It shows that the plan is building the kinds of partnerships that are critical to delivering great care and great service," said Margaret E. O'Kane, President of NCQA.
This most recent evaluation focused on a number of critical operational areas including: quality improvement, network management, utilization management, credentialing, members' rights and responsibilities, and member connections.
"The recognition of our health plans by NCQA is significant because it is an independent review that validates the work we are doing to improve the quality of care for our members," said Dr. Charles DeShazer, senior vice president and chief medical officer, Highmark Health Plan. "Our focus is to provide high-quality, efficient and innovative care for our members. Each and every day, we are working to keep our members healthy and coordinate care with doctors so that our members live healthier lives. We're proud of the work we do, and we're honored to receive this designation and ratings in the areas that we serve."
Each year NCQA rates more than 1,000 health insurance plans in all 50 states. NCQA rates health plans on clinical quality, member satisfaction, and Accreditation survey results.
National Committee for Quality Assurance (NCQA) is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and recognizes clinicians in key clinical areas. NCQA's HEDIS® is the most widely used performance measurement tool in health care. NCQA's Web site (www.ncqa.org) contains information to help consumers, employers and others make more informed health care choices.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).
Highmark Inc. and its health insurance subsidiaries and affiliates collectively are one of America's largest health insurance organizations and together with its Blue-branded affiliates, collectively comprise the third-largest overall Blue Cross and Blue Shield-affiliated organization in the country based on capital. Highmark Inc. and its affiliates operate health insurance plans in Pennsylvania, Delaware and West Virginia that serve approximately 4.6 million members and hundreds of thousands of additional individuals through the BlueCard® program. Its diversified businesses serve group customer and individual needs across the United States through dental insurance, vision care and other related businesses. Highmark Inc. is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. For more information, visit www.highmark.com.
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Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Highmark Blue Cross Blue Shield of Western New York serves eight counties in Western New York and Highmark Blue Shield of Northeastern New York serves 13 counties in Northeastern New York. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.
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