Newsroom

October 26 , 2007
Tufts Health Plan is Ranked Second in the Nation for HMO and POS Plans, and its Medicare Advantage Plan is Ranked Third By The National Committee for Quality Assurance, U.S. News & World Report

Watertown, Mass. - Based on criteria that measured clinical performance and member satisfaction among 259 of the nation's health plans, Tufts Health Plan today announced that it has been named number two in the country for both HMO/POS combined products for a second consecutive year, and achieved a third place ranking for its Medicare Advantage program for the second year in a row by U.S. News & World Report and the National Committee for Quality Assurance (NCQA).

The announcement of plan rankings, part of the in-depth "America's Best Health Plans" feature article released today, illustrates the commitment of Tufts Health Plan to continuous quality improvement and evidence-based medicine.

"We continue to advance the use of evidence-based medicine in our medical management programs as we believe that it is the foundation of good medical practice and is a responsible way to address the issue of rising cost in health care. Therefore, it is gratifying to achieve this sustained recognition of our commitment to clinical excellence," says Allen Hinkle, M.D., Tufts Health Plan's senior vice president and chief medical officer. Our members and customers benefit from this philosophy and the close working relationships we share with the provider community."

Tufts Health Plan achieved this ranking by performing at a high level on several dimensions of care, including preventative health screenings for children and pediatric immunizations; preventative screenings for colorectal and breast cancer; prenatal care; treatment of chronic diseases, especially heart disease and diabetes; member satisfaction; overall health care, and the rating of primary care provider and specialists.

In addition, through its accreditation process, NCQA has awarded Tufts Health Plan's HMO/POS combined products and Tufts Health Plan Medicare Preferred, Excellent accreditation status. According to Margaret E. O'Kane, president of NCQA, "Achieving NCQA's Excellent accreditation status, the organization's highest accreditation level, is a significant achievement. It is only awarded to those plans that meet or exceed NCQA's rigorous requirements for consumer protection and quality improvement, and have HEDIS results in the highest range of national performance."

The NCQA accreditation survey process includes on-site and off-site evaluations of more than 60 standards and selected HEDIS performance measures conducted by a team of physicians and managed care experts. A committee of physicians analyzes the team's finding and assigns an accreditation level based on the performance of the plan according to NCQA's standards.

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 physicians and physician groups in key clinical areas. NCQA's Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care.

Tufts Health Plan is a nationally recognized leader in providing comprehensive, quality health care coverage.

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