PITTSBURGH, Aug. 28, 2012 /PRNewswire/ -- Keystone Health Plan West, Inc. (KHPW), Highmark's health maintenance organization in western Pennsylvania, has achieved national recognition for quality as the plan was recently awarded the "Excellent" Accreditation status by the National Committee for Quality Assurance (NCQA).
Every three years the KHPW managed care plan undergoes an external quality review organization assessment by NCQA to satisfy the Pennsylvania Department of Health managed care regulations. For KHPW, the plan seeks NCQA Accreditation. For more than 10 years the KHPW Accreditation status assigned for the Commercial HMO and Medicare Advantage HMO products by NCQA has been "Excellent."
"This continued recognition by NCQA is very significant. NCQA is widely known as having the most rigorous and thorough program that evaluates health plans," said Carey Vinson, M.D., vice president, quality and medical performance management at Highmark. "This says to our millions of members that Highmark's operations are strong and that Highmark spends a great deal of time and effort to ensure quality and safety is a top priority."
NCQA HP 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.
This most recent evaluation of KHPW focused on a number of critical operational areas including: quality improvement, utilization management, credentialing/recredentialing, member rights and responsibilities and member connections.
"As more members are getting increasingly involved in their health care, the member satisfaction evaluation is very important," said Vinson. "We want to make sure that Highmark has the latest transparency tools so members have the most relevant information as they seek care."
Vinson also noted that health plans with NCQA accreditation generally outperform plans that do not have such recognition.
Highmark Inc., based in Pittsburgh, is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. Highmark serves 4.9 million members in Pennsylvania, West Virginia and Delaware through the company's health care benefits business and is one of the largest Blue plans in the nation. Highmark has 20,000 employees across the country and provides a broad range of health and wellness related services through subsidiary and affiliate companies. For more information, visit www.highmark.com.
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.
SOURCE Highmark Inc.