The National Committee for Quality Assurance (NCQA)

The National Committee for Quality Assurance (NCQA) has awarded Medical Mutual’s commercial products an accreditation status of Excellent – the highest level achievable. In addition, Medical Mutual’s Medicare Advantage products were reviewed by NCQA and awarded Commendable Status. (Medicare plans reviewed by NCQA receive Commendable Status or nothing.)

The following commercial products are included in the Excellent Accreditation Status:

• Preferred Provider Organization (PPO) plans (SuperMed Plus® and Ohio Med™)
• Health Maintenance Organization (HMO) plans (HMO Health Ohio® and SuperMed HMO®)
• Point-of-Service (POS) plans (SuperMed Select® and SuperMed Preferred)

The good news means Medical Mutual’s HMO and POS plans have maintained their Excellent Accreditation Status under the Managed Care Organization ( MCO) accreditation review. It also indicates Medical Mutual’s PPO plans received Excellent Accreditation Status the first time they were evaluated under MCO accreditation review. (Previously, Medical Mutual submitted its PPO plans under the PPO accreditation review. For the most recent evaluation, the Company decided its PPO plans would be evaluated under MCO accreditation review, which has higher, more rigorous standards.)

The Excellent Accreditation Status was awarded after rigorous evaluation by NCQA of all aspects of Medical Mutual’s plans, including preventive health services, member satisfaction, physician credentialing and quality improvement.

The review included both on- and off-site evaluations conducted by a team of physicians and managed care experts. A national oversight committee of physicians then analyzed the team’s findings and assigned Medical Mutual’s Excellent Status based on the Company’s performance compared to the NCQA standards.

Our accreditation achievement is important because health plans earning NCQA Accreditation tend to substantially outperform non-accredited health plans across a wide range of measures of clinical quality and member satisfaction. Medical Mutual’s achievement is also significant because its PPO plans were submitted under higher standards than required for PPO products and were awarded Excellent Accreditation Status. Through accreditation, NCQA recognizes Medical Mutual’s commitment to provide quality healthcare to its members and that the Company has incorporated quality improvements into its business structure.

For more information, visit ncqa.org

URAC ©

Medical Mutual has earned Full Accreditation for its Utilization Management and Case Management programs from URAC, a non-profit organization that establishes standards for the Managed Care industry. Full Accreditation is the highest level of accreditation awarded by URAC.

"Medical Mutual has always been dedicated to providing continuous quality improvement to its members," says Paula Sauer, Vice President of Care Management. "This accreditation confirms we offer the highest level of clinical integrity in the areas of utilization and case management."

URAC is an independent, nonprofit healthcare accrediting organization dedicated to promoting healthcare quality through accreditation, certification, and commendation.

URAC accreditation provides assurance to patients, healthcare professionals, purchasers, regulators, and employers that the practices of the organization performing these services are fair and equitable for all parties.

In addition, the URAC accreditation process is important because it demonstrates a commitment to quality services and serves as a framework to improve business processes by benchmarking organizations against nationally recognized standards.

For more information, visit urac.org