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Excellent. That is the rating that Wellmark Health Plan of Iowa was given by NCQA. Wellmark Health Plan of Iowa has maintained the highest accreditation status from NCQA since 2001. The “Excellent” status is based in part on the ongoing improvements Wellmark Health Plan of Iowa has made on its HEDIS^® scores and member satisfaction scores. It is granted only to plans that demonstrate levels of service and clinical quality that meet or exceed NCQA’s rigorous requirements for consumer protection and quality improvement. The Wellmark Health Plan of Iowa products include Blue Access, Blue Advantage and Blue Choice.

At the health plan's request, NCQA sends a team of trained health care experts, including physicians, to conduct a rigorous on-site survey of the health plan. NCQA uses information from health plan records, consumer surveys, interviews with health plan staff, and performance on selected HEDIS® measures. No one affiliated with the health plan is involved in the on-site survey or the Accreditation Decision.

NCQA Standards for Accreditation are intended to help organizations achieve the highest level of performance possible, reduce patient risk for adverse outcomes, and create an environment of continuous improvement.

There are approximately 60 standards for quality that are publicly reported in five categories:

• Access and Service
• Qualified Providers
• Staying Healthy
• Getting Better
• Living with Illness

Access and Service - Do health plan members have access to the care and service they need? For example: are doctors in the health plan free to discuss all treatment options available? Do patients report problems getting needed care? How well does the health plan follow up on grievances?

Qualified Providers - Does the health plan assess each doctor's qualifications and what health plan members say about their providers? For example: does the health plan regularly check the licenses and training of physicians? How do health plan members rate their personal doctor or nurse?

Staying Healthy - Does the health plan help people maintain good health and avoid illness? Does it give its doctors guidelines about how to provide appropriate preventive health services? Are members receiving tests and screenings as appropriate?

Getting Better - How well does the health plan care for people when they become sick? How does the health plan evaluate new medical procedures, drugs and devices to ensure that patients have access to safe and effective care?

Living with Illness - How well does the health plan care for people with chronic conditions? Does the plan have programs in place to assist patients in managing chronic conditions like asthma? Do diabetics, who are at risk for blindness, receive eye exams as needed?

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).