Each year we use a set of tools that are managed by outside groups to measure how we are doing and see where we can improve our services. They include:
Healthcare Effectiveness Data and Information Set (HEDIS®)
Horizon BCBSNJ works to improve the quality of care provided to our members through participation in the National Committee for Quality Assurance (NCQA) Accreditation Survey. NCQA created the Healthcare Effectiveness Data and Information Set (HEDIS®). These measures are used to rate health care organizations. They rate quality of care, access to care and member satisfaction. The NCQA seal is a widely recognized symbol given to an institution that is well managed and delivers high-quality care and service. Organizations that have earned NCQA designation have passed a rigorous, comprehensive review and annual performance report to earn an accreditation.
Our Quality Management department measures HEDIS compliance on an ongoing basis. Annually, Horizon BCBSNJ submits HEDIS data to NCQA - it is scored and tabulated to be included in Horizon BCBSNJ’s accreditation results.
Visit ncqa.org for more information and a summary of HEDIS results grouped by health plan.
The Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey
The Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey asks consumers and patients about their experiences with health care. The CAHPS survey covers topics that are important to our members and focuses on aspects of quality that members are best qualified to assess, such as the communication skills of providers and ease of access to health care services.
Visit cahps.ahrq.gov for more information and copies of all CAHPS surveys. Anyone can download and use these surveys to assess experiences with health care.
HEDIS® is a registered trademark of the National Committee for Quality Assurance.
CAPHS® is a registered trademark of the Agency for Healthcare Research and Quality.