Excellus BlueCross BlueShield Earns Highest National Accreditation for Quality

ROCHESTER, NY (05/05/2009)(readMedia)-- The managed care plans of Excellus BlueCross BlueShield have again received the highest accreditation status available, a rating of "Excellent," from the National Committee for Quality Assurance (NCQA). The rating applies to the health plan's commercial, Medicare and Medicaid HMO and point-of-service (POS) products.

Excellus BCBS is also the first health plan in New York state to receive an Excellent Accreditation for its commercial and Medicare preferred provider organizations (PPO) products. Excellus BCBS received this "Excellent" rating under NCQA's new and comprehensive Health Plan Accreditation program that applies the same rigorous standards to PPO products as it does to HMO and POS products.

NCQA is a private, nonprofit organization dedicated to improving health care quality. Employers and consumers use information from NCQA to make more informed health care choices. "NCQA's Excellent Accreditation status is reserved for the best health plans in the nation," said Margaret E. O'Kane, NCQA president. "It is only awarded to those plans that meet or exceed NCQA's rigorous requirements for consumer protection and quality improvement and deliver excellent clinical care."

To become accredited by NCQA, a health plan must undergo a rigorous evaluation of more than 60 standards designed to evaluate its clinical and administrative systems. NCQA 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. Full accreditation is effective for a three-year period.

"The NCQA seal of excellence affirms that our members are receiving the highest quality of care," said Christopher C. Booth, Executive VP, Commercial Markets and Health Care Affairs, Excellus BCBS. "It not only reflects the hard work and dedication of our employees, but also reflects the quality of our community's doctors and hospitals."

Health plans earning Excellent Accreditation must also achieve NCQA's Health Effectiveness Data and Information Set (HEDIS®) results that are in the highest range of national or regional performance. HEDIS is the nation's most widely used set of clinical quality measures.

NCQA began accrediting managed care organizations in 1991 in response to the need for standardized, objective information about the quality of these organizations. In July 2008, NCQA began evaluating PPO's on a set of standards similar to their review of managed care organizations, including an assessment of their complex case management and disease management programs and how well they ensure continuity and adequate coordination of patients' care.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)

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Excellus BlueCross BlueShield, a nonprofit independent licensee of the BlueCross BlueShield Association, is part of a family of companies that finances and delivers vital health care services to 1.8 million people across upstate New York. Excellus BlueCross BlueShield provides access to high-quality, affordable health coverage, including valuable health-related resources that our members use every day, such as cost-saving prescription drug discounts and wellness tracking tools in our Step Up program. To learn more, visit www.excellusbcbs.com