Leading Health Plans Score High In Quality

Washington, D.C. – Independent and locally-managed health plans that are not-for-profit and provider-based, and affiliated with the Alliance of Community Health Plans (ACHP), surpassed the National Committee for Quality Assurance’s (NCQA) 1998 Quality Compass averages in all areas.

“Effectiveness of Care” performance measurements in this anaylsis include: childhood immunizations; advising smokers to quit; breast cancer screening; cervical cancer screening; prenatal care in first trimester; diabetic retinal examinations; follow-up after hospitalization for selected mental illness; check-ups after delivery; and, the appropriate administration of Beta Blockers after a heart attack (see attached chart).

“Patients are enjoying improved access to excellent care because these plans have remained true to their historic missions to enhance the quality of care to individuals. They expend their resources on conducting continuous improvement activities, promoting the practice of evidence-based medicine and fostering close collaborative partnerships with physicians and patients,” said Daniel Wolfson, ACHP president and CEO.

In support of the highest standards of health care performance, the Alliance works with the nation’s leading health plans including: AvMed Health Plan; Fallon Community Health Plan; Family Health Plan Cooperative; Group Health Cooperative of Puget Sound; Group Health Cooperative of South Central Wisconsin; Group Health Northwest; Harvard Pilgrim Health Care; Harvard Pilgrim Health Care of New England; Health Alliance Plan; Health Alliance Medical Plans; HealthCarePlan; HIP Health Plans; Health Services Medical Corporation; HealthPartners; Kaiser Permanente Medical Care Program (of Rocky Mountain, Southeast, Central East, Hawaii, CHP/Northeast, and Northwest Divisions); M Plan; and, Scott & White Health Plan.

These plans also collaborate on pioneering shared improvement projects in key areas like smoking, coronary heart disease and depression. “This enables physicians and clinicians to raise the quality bar by sharing ideas with their colleagues, devising best practices, and creating solutions to enhance patient access to appropriate care,” Wolfson added.


Independent and locally-managed health plans continue to score among the highest in performance measurements in an analysis of the latest HEDIS® (Health Plan Employer Data and Information Set) quality indicator results.

ACHP NCQA Quality Average Compasss Average
Childhood Immunizations (Comb. #1) 77.8 65.4
Advising Smokers to Quit 69.0 64.2
Breast Cancer Screening 76.6 71.2
Cervical Cancer Screening 77.2 71.3
Prenatal Care in First Trimester 88.4 83.1
Diabetic Retinal Exams 53.5 39.0
Beta Blockers after a Heart Attack 78.7 74.0
Follow-Up After Hospitalization for Selected Mental Illness 77.0 67.3
Check-Ups After Delivery 72.5 66.1

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

Bill Rovner:             (732) 220-1388      ; e-mail: brovner@achp.org
Aylin Gonen:             (202) 667-0901      ; e-mail: ayling@twbg.com