The State of New Jersey
NJ Department of Banking and Insurance
search  

 
Home > Insurance Division > Life and Health > Life & Health Actuarial > HMO and PPO Performance Report
2015 New Jersey HMO and PPO Performance Report
Staying Healthy

Does the HMO or PPO help members stay healthy and avoid illness?

HMOs and PPOs should work with doctors to provide important preventive services that help members stay healthy. HMOs and PPOs reported on the percentage of their relevant membership who received the following services:

  • Breast cancer screening
  • Cervical cancer screening
  • Colorectal cancer screening
  • Immunizations for children
  • Immunizations for adolescents

The following table shows how well each HMO and PPO performed. The bar graphs following show the HMOs and PPOs compared to the New Jersey average.


HMO & PPO
Breast cancer
screening %
Cervical
cancer screening %
Colorectal
cancer screening%
Immunizations
for
children %
Immunizations for adolescents %
HMO
Aetna - HMO/POS
69
77
64*
77*
75
AmeriHealth - HMO/POS
69
74
54
77
85
Cigna - HMO/POS
71
84
62
79*
83*
Horizon - HMO
66
76
62*
79
77*
Oxford - HMO/POS
67
79
53*
69
65
PPO
Aetna - PPO/EPO
68
79
58
75*
69
AmeriHealth - PPO/EPP
71
76
54
79
85
Cigna - PPO
65
78
57
80*
84*
Horizon - PPO/EPO
62
72
58
75
72*
Oxford - PPO/EPO
70
80
53*
75
61
United - PPO/EPO
67
80
58*
75
70
*2013 data
 

Breast cancer screening

Mammograms are recommended for detection of breast cancer. The bar graphs show the percentage of women aged 42–69 who received a mammogram within the past two years.

A higher percentage rate is better for the breast cancer screening measure. It shows that more women did get a mammogram within the measurement year.

HMO   PPO
HMO - Breast Cancer Screening   PPO - Breast cancer screening
     
Cervical cancer screening

Pap smears are recommended for detection of cervical cancer.
The bar graphs show the percentage of women aged 21–64 who received a Pap test within the past three years.

A higher percentage rate is better for the cervical cancer screening measure. It shows that more women did get a Pap test within a given timeframe.

HMO   PPO
HMO - Cervical cancer screening
  PPO - Cervical cancer screening
 
Colorectal cancer ccreening

Colonoscopy is recommended to look for early signs of colorectal cancer. The bar graph shows the percentage of members aged 50-75 who had appropriate screening for colorectal cancer.

A higher percentage rate is better for the colorectal cancer screen measure. It shows that more adults in the 50-75 age group did get screened for colorectal cancer.


HMO   PPO
HMO - Colorectal cancer screening
 
PPO - Colorectal cancer screening
*2013 data   *2013 data
     
Immunizations for children

Immunizations prevent childhood diseases such as polio, measles, mumps, rubella and whooping cough. The bar graphs show the percentage of children who received recommended immunizations by age two.

A higher percentage rate is better for the childhood immunization status. A higher percentage shows that more children did get all their required immunizations.

HMO   PPO
HMO - Immunizations for children
 
PPO - Immunizations for children
*2013 data   *2013 data
     
Immunizations for adolescents

Adolescent immunizations prevent adolescent diseases such as meningococcal, tetanus, diphtheria toxoids and acellular pertussis. The bar graphs show the percentage of adolescent children who received recommended immunizations by age 13 in the measurement year 2014.

A higher percentage rate is better for the adolescent immunization status. A higher percentage shows that more adolescent children who turned 13 years of age during the measurement year got all their required immunizations.
HMO - Immunizations for children
 
PPO - Immunizations for children
*2013 data   *2013 data
 
OPRA
OPRA is a state law that was enacted to give the public greater access to government records maintained by public agencies in New Jersey.
line
Adobe Acrobat
You will need to download the latest version of Adobe Acrobat Reader in order to correctly view and print PDF (Portable Document Format) files from this web site.
state seal
Copyright © 2011, State of New Jersey
New Jersey Department of Banking and Insurance