BlueChoice and BluePreferred Awarded Highest NCQA Approval
Our
two regional health plans - BlueChoice and BluePreferred - recently received
the National Committee of Quality Assurance's (NCQA) highest accreditation.
NCQA is a non-profit organization that measures the quality of America's
health care.
BluePreferred, among the first Preferred
Provider Organizations (PPO) in the nation to seek accreditation, was
granted Full accreditation. This is NCQA's highest level of accreditation
possible for a PPO. BluePreferred scored 96.9 points (out of a possible
100). A score of at least 80 is required to achieve Full status.
CareFirst BlueChoice, our new regional HMO,
received an Excellent accreditation, the highest NCQA accreditation awarded
for an HMO. BlueChoice scored 92.9 points (out of a possible 100). A score
of 90 is required to achieve Excellent status.
NCQA President Margaret E O'Kane said, "earning
Excellent Accreditation reflects a health plan's ability to work with
their members and their physicians to improve the quality of clinical
care. It shows that they are building the kinds of partnerships that are
critical to delivering great care and great service." The accreditations
awarded to BluePreferred and BlueChoice will remain effective for the
next three years.
"NCQA evaluates how well a health plan
manages all parts of its delivery system-physicians, hospitals, and other
providers and administrative services-in order to continuously improve
health care for its members," said O'Kane.
Their mission is to provide information that
enables purchasers and consumers of managed health care to distinguish
among plans based on quality, thereby allowing them to make more informed
health care purchasing decisions.
NCQA's accreditations are viewed by purchasers,
consumers and health plans as an objective measure of the quality of health
care services provided by health plans. Because of the competitive nature
of the health care market, a NCQA accreditation is vital to the success
of CareFirst. Some of our accounts require NCQA accreditation as a condition
of doing business with CareFirst.
The standards and performance measures that
are utilized in determining a plan's accreditation are:
- Access and service
- Qualified providers
- Staying healthy
- Getting better
- Living with illness
