HARRISBURG, Pa.--(BUSINESS WIRE)--AmeriHealth Caritas Pennsylvania, a Medicaid managed care plan that serves central and northwestern Pennsylvania and part of the AmeriHealth Caritas Family of Companies, is one of the highest-rated health insurance plans in the nation, having earned a rating of 4.5 out of 5 in the National Committee for Quality Assurance’s (NCQA’s) Medicaid Health Insurance Plan Ratings 2019-2020. In addition, AmeriHealth Caritas Pennsylvania has earned an “Excellent” health plan accreditation status from NCQA; this is NCQA’s highest health plan accreditation status level.
“Our health plan rating and ‘Excellent’ accreditation status are testaments to the commitment of our team to provide the best service and best clinical care that our members deserve,” said AmeriHealth Caritas Pennsylvania Market President Marge Angello. “We are continuing to push ourselves to provide holistic, whole-person care and remove the barriers that prevent members from achieving healthy outcomes.”
AmeriHealth Caritas Pennsylvania earned its 4.5 out of 5 rating based on strong results from the Healthcare Effectiveness Data and Information Set (HEDIS®), a tool that measures performance on important dimensions of care and service, as well as the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey, which measures members’ satisfaction with their overall health care experience.
AmeriHealth Caritas Pennsylvania also improved its accreditation status from “Commendable” to “Excellent” through ongoing evaluation and continuous quality improvement.
“It is partly a health plan’s members that determine whether it earns NCQA’s Excellent Accreditation status. Any plan that does so should be proud of its accomplishment. It is a sign that the plan’s delivering great service and great care—it’s met the toughest test in managed care,” said NCQA President Margaret E. O’Kane.
NCQA Health Plan Accreditation is a nationally recognized evaluation that purchasers, regulators and consumers can use to assess health plans. NCQA Accreditation not only involves a rigorous review of a health plan’s consumer protection and quality improvement systems, but also requires health plans to submit audited data on key clinical and service measures (e.g., mammography screening rates; smoking cessation) in order to achieve the highest levels of accreditation.
NCQA accreditation status is based on rigorous on-site and off-site evaluations of over 60 standards and selected Healthcare Effectiveness Data and Information Set (HEDIS®) measures. NCQA awards a status of Excellent to organizations for service and clinical quality that meet or exceed NCQA's rigorous requirements for consumer protection and quality improvement.
NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and recognizes clinicians in key clinical areas. NCQA’s HEDIS® is the most widely used performance measurement tool in health care. NCQA's website (www.ncqa.org) contains information to help consumers, employers and others make informed health care choices. NCQA’s website (ncqa.org) contains information to help consumers, employers and others make more informed health care choices. NCQA can be found online at ncqa.org, on Twitter @ncqa, on Facebook at facebook.com/NCQA.org/ and on LinkedIn at linkedin.com/company/ncqa.
About AmeriHealth Caritas Pennsylvania
AmeriHealth Caritas Pennsylvania is a Medical Assistance (Medicaid) managed care health plan serving 26 counties in Central and Northwestern Pennsylvania. Headquartered in Harrisburg, Pennsylvania, AmeriHealth Caritas Pennsylvania is a mission-driven company dedicated to helping members get care, stay well and build healthy communities. For more information, visit www.amerihealthcaritaspa.com.
About AmeriHealth Caritas
AmeriHealth Caritas is one of the nation’s leaders in health care solutions for those most in need. Operating in 12 states and the District of Columbia, AmeriHealth Caritas serves more than 5 million Medicaid, Medicare, and Children’s Health Insurance Program (CHIP) members through its integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, and behavioral health services. Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 35 years of experience serving low-income and chronically ill populations. AmeriHealth Caritas is part of the Independence Health Group in partnership with Blue Cross Blue Shield of Michigan. For more information, visit www.amerihealthcaritas.com.
HEDIS® is a registered trademark of NCQA.
CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).