Published July 12, 2012
The National Committee for Quality Assurance, or NCQA, awarded the commercial health plan a three-year accreditation after evaluating the quality of health care and customer service BlueChoice provides to its members. BlueChoice has been accredited at the highest level since 1994.
NCQA is a private, nonprofit organization dedicated to improving health care quality.
"It is partly a health plan's members that determine whether it earns NCQA's excellent accreditation status," said Margaret E. O'Kane, NCQA's president. "It is a sign that the plan's delivering great service and great care — it's met the toughest test in managed care."
A team of physicians and health plan experts conducts accreditation surveys. The surveys include evaluations of more than 60 standards and selected Healthcare Effectiveness Data and Information Set, or HEDIS, measures. More than 90% of U.S. health plans use HEDIS to measure performance on important dimensions of care and service, such as whether members with chronic conditions get recommended screening tests, or whether children get immunizations on time.
"We voluntarily submit data to NCQA so that the quality of our health and wellness programs for members, as well as our overall customer service, can be evaluated by an independent third party," said BlueChoice President Mary Mazzola Spivey. "The fact that we are accredited at the highest possible level demonstrates our commitment to work with health care providers and our members to improve health care quality and provide demonstrated value."
BlueChoice's wellness and disease management programs are an important part of its efforts to improve health, BlueChoice said. BlueChoice said it provides its healthy members with guidelines and support for staying well, and provides information and health coaching to help those with chronic conditions learn to better manage their illnesses.
Headquartered in Columbia, BlueChoice HealthPlan of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association, and is a subsidiary of BlueCross BlueShield of South Carolina.