HARTFORD, Conn.–(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.
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.
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.
Ethan Slavin, 860-273-6095