Network Health Earns “Excellent” Accreditation and is Rated 3rd Medicaid Health Plan in the United States by National Committee for Quality Assurance for Second Time

<0> Tufts Health PlanSonya Hagopian, 617-972-1090VP, Corporate Communications and Public Relations </0>

Network Health, a nonprofit health plan and Tufts Health Plan subsidiary that provides access to comprehensive health coverage for nearly 220,000 Massachusetts residents, announced today that it received the highest possible accreditation rating, and was rated the 3 Medicaid Health Plan in the United States by the National Committee for Quality Assurance (NCQA), for the second year in a row.

Network Health earned NCQA’s “Excellent” Health Plan Accreditation for its (MassHealth) plan after a rigorous review. The three-year accreditation runs through July 2, 2016. NCQA’s Health Plan Accreditation, developed with input and support from health plans, purchasers, unions, and consumer groups, is the nation’s most-trusted and comprehensive independent source for evaluating health care quality and value. To earn NCQA accreditation, health plans face a challenging set of more than 60 standards and must report on their performance in more than 40 areas.

“We are pleased to have once again received NCQA’s ‘Excellent’ Health Plan Accreditation and to maintain our position as a high ranking health plan nationally,” said Paul Kasuba, chief medical officer at Tufts Health Plan. “These awards reflect Network Health’s unwavering dedication to providing top-quality service and care to our members. We are proud of our team and looking forward, will continue to strive for improvement and innovation in all that we do.”

NCQA designs its Health Plan Accreditation and rating system to evaluate the core systems and processes that make up a health plan and the health plan’s key dimensions of care, service, and efficiency results. The accreditation process involves on-site and off-site evaluations by physicians and managed care experts. NCQA’s Health Plan Accreditation is the only program in the nation that includes a clinical care and patient experience exam.

NCQA, through its Health Plan Accreditation, scores health plans on the results of three major components: Health Effectiveness Data and Information Set (HEDIS), a yearly evaluation of performance in key areas of clinical care and customer service; Consumer Assessment of Healthcare Providers and Systems (CAHPS), a yearly survey of plan members’ satisfaction with the quality and services they receive; and an Accreditation Survey, an assessment of the plan’s quality-related policies, systems, and procedures. NCQA’s Health Insurance Plan Rankings list health insurance plans based on their combined HEDIS, CAHPS, and NCQA Accreditation standards scores.

Since 1997, Network Health has provided access to high-quality health care for Massachusetts residents with low and moderate incomes. Network Health is a nonprofit, comprehensive health plan serving members through (MassHealth), (Commonwealth Care), (Medical Security Program), (an individual and small-group plan), and (Medicare-Medicaid One Care for people ages 21 – 64).

To improve the health and well-being of its more than 215,000 members and their diverse communities, Network Health offers fully integrated, in-house care management, providing a team of medical, behavioral health, social care, and pharmacy professionals who coordinate member care. Network Health partners with more than 20,000 primary care providers, specialists, hospitals, and community organizations statewide.

Network Health is among 10 health plans nationally and the first health plan in New England to earn the NCQA Multicultural Health Care Distinction. Additionally, Network Health is nationally recognized for its innovative programs; it won the Dorland Health Case In Point Platinum Award for “Best Social Care Management Team” in 2013, “Best Integrated Case Management Team” in 2012 and “Best Overall Case/Care Management Program” in 2010. Network Health is also recognized for its top leadership team among health plans nationwide by HealthLeaders Media.

Network Health became a subsidiary of Tufts Health Plan in 2011. Tufts Health Plan is a nonprofit organization nationally recognized for its commitment to providing innovative, high-quality health care coverage to its more than 1,000,000 members. Tufts Health Plan is one of the few health insurers in Massachusetts to participate in the commercial, Medicare and Medicaid/subsidized markets, offering coverage across the life span regardless of age or circumstance. Its HMO and PPO plans are continually ranked in the top 10 of insurance plans across the country by the National Committee for Quality Assurance (NCQA). Its Tufts Medicare Preferred HMO earned a 4.5 star rating from the Centers for Medicare and Medicaid Services for 2013.

For more information about Network Health, call or visit . Follow Network Health on and @_NetworkHealth on .

To learn about health plan options, Massachusetts residents can call the Health Connector at 877-636-4654 (TTY: 877-623-7773), Monday through Friday, from 8:30 a.m. to 6 p.m., or visit ; call MassHealth at 800-841-2900 (TTY: 800-497-4648), Monday through Friday, from 8 a.m. to 5 p.m., or visit ; or call the Medical Security Program at 800-908-8801, Monday through Friday, from 8:30 a.m. to 4:30 p.m., or visit .

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

CAHPSis a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).

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