Mid-Atlantic Medical Services Inc. of Rockville announced yesterday that it has received one-year accreditation from the National Committee for Quality Assurance for its HMO plans.
MAMSI is the only HMO in Maryland to have been denied NCQA accreditation -- an action taken after a 1994 review. The more favorable decision came after a review in December.
The announcement comes a day after MAMSI posted its first positive quarter in a year, earning $806,000, or 2 cents a share, in the first quarter of 1997 but still less than the 4-cents-a-share average estimate by 11 analysts surveyed by I/B/E/S International.
It was 93.2 percent lower than the $11.9 million posted in the first quarter of 1996, but followed three quarters of losses.
MAMSI was able to reduce medical expenses to 90.2 percent of premiums, down from 93.9 percent in the last quarter of 1996. Michael Savage, manager of communications for MAMSI, said the company was able to control medical costs by roughly doubling its number of utilization-review nurses, to about 85. The utilization-review staff both reviews care for members and examines new members to develop preventive plans, Savage said.
Revenue for the first quarter was $283.2 million, up 4.3 percent from $271.6 million in the corresponding quarter of 1996. This reflects some increases in premiums and a rise in membership of FTC 8.6 percent, to 1,711,700.
Savage said the largest problem in the negative 1994 accreditation report had been in the procedures that MAMSI used to review doctor's credentials -- a system MAMSI has since changed.
NCQA did not release information on reports when the 1994 review was done. It now releases summaries of accreditation reviews, but has not yet done so for MAMSI.
According to NCQA, 49 percent of the plans it has reviewed earned full, three-year accreditation while 34 percent earn one-year approval. Another 7 percent have provisional accreditation; 8 percent have been denied accreditation; and 2 percent are under review.
Among Maryland plans, one other has one-year accreditation, United of the Mid-Atlantic, which was Chesapeake Health Plan when it was reviewed in 1995. Those with full, three-year approval are the plans owned by Blue Cross Blue Shield of Maryland -- CareFirst, Columbia, FreeState and Potomac; Aetna
U.S. Healthcare; Cigna; Kaiser; NYLCare and Prudential.
MAMSI shares closed yesterday at $13.375, up 50 cents.
Pub Date: 5/16/97