Health
Plan Accreditation
Blue Cross and Blue Shield of New Mexico's PPO plan and HMO
New Mexico, Inc., are accredited by the National Committee
for Quality Assurance (NCQA). Our PPO plan was awarded a "Full
Accreditation," and HMO New Mexico
was awarded a "Commendable" rating. The
NCQA accreditation process is the most widely recognized national
evaluation that consumers, purchasers, and regulators use to assess
and compare the caliber of managed care plans.
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PPO
Accreditation
BCBSNM’s PPO plan, effective October
16, 2002, received a Full Accreditation. BCBSNM
is the only health plan in New Mexico with an NCQA accreditation
for a PPO product as of October 15, 2002. |
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HMO
Accreditation
HMONM was notified August 29, 2003,
that we have maintained the Commendable rating based on
the most recent HEDIS and CAHPS results. HMONM was awarded
Commendable Accreditation effective October 16, 2002. (In
November 2000, HMONM also received Commendable Accreditation.) |
NCQA is an independent, not-for-profit organization that evaluates managed
care organizations and maintains the Health Plan Employer Data
and Information Set (HEDIS®), a set of standardized performance measures
designed to ensure consumers have the information
they need to compare the performance of managed health
care plans. More
than 60 standards and selected HEDIS® performance
measures were evaluated by a team of physicians in such areas as
member rights and responsibilities, quality management and improvement,
clinical services, preventive health, utilization management, and
the credentialing process for network physicians and other providers.
The Consumer Assessment of Health Plans (CAHPS®) 2.0H Commercial
Adult Member Satisfaction Survey is a set of survey tools used
to assess patients' satisfaction with their health plans. The CAHPS® survey
is applied to a random sample of BCBSNM/HMONM health plan members,
and provides findings by plan service area and by each individual
question. Developed
jointly by the Agency for Healthcare Research and Quality (AHRQ)
and NCQA, the CAHPS® 2.0H
survey is the most comprehensive tool available for assessing consumers'
experiences with their health plans.
HEDIS® is a registered trademark of the National Committee
for Quality Assurance (NCQA).
CAHPS® is a registered trademark of the Agency for Healthcare Research
and Quality (AHRQ), a U.S. Government agency.
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