Saint Mary's HealthFirst HMO/POS is a proud recipient of the accreditation rating of Commendable from the National Committee for Quality Assurance (NCQA).

This accreditation rating recognizes that Saint Mary's HealthFirst delivers high-quality care and service, and the Plan's systems for consumer protection and quality improvement meet or exceed NCQA's rigorous requirements.

What is NCQA?
NCQA is an independent, not-for-profit organization that evaluates and rates managed care organizations and is widely recognized by employers, consumers and others as the most trusted, reliable source for information about the quality of the nation's health care system. For more information about NCQA, please visit their website at www.ncqa.org.

Why is NCQA Accreditation important?
NCQA's Accreditation program is designed to help employers and consumers make informed choices among health plans. NCQA Accreditation provides purchasers and consumers with an unprecedented ability to evaluate the quality of different health plans along a variety of important dimensions, and to make their health plan decisions based on demonstrated value rather than simply on cost. Earning NCQA Accreditation helps a health plan distinguish itself on the basis of quality and service. Because of our Commendable NCQA Accreditation rating, you can be confident in your choice of Saint Mary's HealthFirst as your health plan partner!

What areas does NCQA evaluate?
NCQA standards are intended to help health plans achieve the highest level of performance possible, reduce patient risk for untoward outcomes, and create an environment of continuous improvement. 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 annually submit audited data on selected key clinical and services measures, including:

• HEDIS®, Healthcare Effectiveness Data and Information Set-a set of standardized clinical measures developed to assist employers and consumers in comparing a health plan's performance, such as breast cancer screening, comprehensive diabetes care, childhood immunizations, advising smokers to quit, etc.
• CAHPS®, Consumer Assessment of Healthcare Providers and Systems-a standardized survey of consumers' experiences that is conducted annually to evaluate Saint Mary's HealthFirst's performance in such areas as getting needed care, getting care quickly, how well doctors communicate, customer service, and claims processing.

The NCQA Standards for Accreditation, and the Plan's HEDIS®/CAHPS® results, are publicly reported in five categories:

• Access & Service - NCQA evaluates how well the health plan provides its members with access to needed care and customer service.
• Qualified Providers - NCQA evaluates the health plan's activities that ensure Plan physicians are licensed and trained to practice medicine and what the Plan's members say about their providers.
• Staying Healthy - NCQA evaluates the health plan's activities that help people maintain good health and detect illness early.
• Getting Better - NCQA evaluates how well the health plan cares for members when they become ill
• Living with Illness - NCQA evaluates the health plan's activities that help people manage chronic illness.