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November 22, 2006

UPMC on U.S. News honor roll

A report from U.S. News & World Report and the National Committee for Quality Assurance (NCQA) has placed UPMC Health Plan on the “honor roll” of the top 10 health plans in the country. The report, “America’s Best Health Plans,” also shows that the health plan is the highest ranked plan in Pennsylvania for the second year in a row.

The rankings, which include more than 320 plans, are based on a combination of clinical performance, member satisfaction and NCQA accreditation status.

The health plan registered the top scores statewide in several measures of care, including women’s health (timeliness of prenatal and postpartum care) and children’s health (access to primary care physicians for age groups 25 months-6 years, 7-11 years and 12-19 years) and appropriate use of antibiotics and treatment for pharyngitis (sore throat) in children.

UPMC Health Plan also is ranked highest in the state in several behavioral health categories:

• Antidepressant medication management — optimal practitioner contacts;

• Antidepressant medication management — effective continuation phase treatment, and

• Follow-up after hospitalization for mental illness within 30 days.

UPMC Health Plan also received the top score nationwide in breast cancer screening for the third consecutive year. This means health plan female members were screened for breast cancer at a greater rate than were members of any other surveyed health plan in the United States.

Other examples of measures that contributed to the health plan’s ranking include:

• Taking advantage of its relationship with UPMC and Pitt’s School of Medicine to develop innovative preventive health methodology.

• Developing and administering health and care management programs in-house, departing from the industry trend to outsource these services.

• Providing online tools and information through that allow members to track their own health status and research health topics.

• Offering feedback to its provider network and members to identify gaps in service.

Filed under: Feature,Volume 39 Issue 7

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