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Advancing Quality

Our unwavering commitment to quality is rooted in our vision for an innovative, whole-person, well-coordinated system of care that addresses both medical and non-medical drivers of health and promotes health equity. Quite simply, we expect more—from ourselves and for our members, communities, and all stakeholders we serve.

Multiple NCQA Recognitions

The National Committee for Quality Assurance (NCQA) is an independent, not-for-profit organization recognized as a national leader for improvements in health care standards, programs, and quality measurement. Amerigroup proudly holds multiple NCQA accreditations as evidence of our commitment to quality.

Accredited NCQA Health Plan

Each one of our Amerigroup markets holds NCQA Health Plan Accreditation, evidence of our commitment to quality in member experience, clinical performance, and network management.

Accredited NCQA Health Insurance Plan Ratings 2019-2020

Amerigroup affiliates in four states achieved a 4.0/5.0 rating from NCQA for 2019-2020, placing them in the top quarter of Medicaid health plans.

Distinction NCQA MultiCultural Health Care

Amerigroup has earned Multicultural Health Care Distinction status from NCQA, a recognition of our commitment to providing culturally and linguistically appropriate services and reduction in health care disparities to our Medicaid members.

Accredited NCQA Managed Behavioral Healthcare Organization

Accredited NCQA Disease Management

At the national level of Amerigroup’s parent company, the Medicaid division holds:

  • NCQA Managed Behavioral Health Organization accreditation, an acknowledgment of the effectiveness of our integrated care model.
  • NCQA accreditation for nine Disease Management programs, a recognition of the quality supports and services we offer members who are living with a health condition.

Distinction NCQA Long Term Services and Supports

Our Tennessee health plan is proud to be an Early Distinction Adopter and is accredited with LTSS Distinction. Our New Jersey health plan has obtained their LTSS Distinction, and we committed to achieving this accreditation in all of our affiliated qualifying LTSS markets.

Strong Quality Measure Results

NCQA uses numerous quality measures known as the Healthcare Effectiveness Data and Information Set (HEDIS®). A few of our rankings for 2018 that scored in the 90th percentile include:

  • Initiation & Engagement of Alcohol & Other Drug Dependence Treatment - Initiation Total for eight affiliates.
  • Adults Access to Preventive/Ambulatory Health Services – Total for six affiliates.
  • Childhood Immunization Status, including HepB, IPV, MMR and VZV for five affiliates.
  • Well Child Visits in the Third, Fourth, Fifth and Sixth Year of Life for five affiliates.

High Rates of Member Satisfaction

The Consumer Assessment of Healthcare Providers and Systems (CAHPS®) program surveys member experience with a health plan and how well the plan is meeting member expectations. A few of our 2019 rankings that scored in the top 10% include:

  • Rating of Health Plan metric in the Medicaid CAHPS survey for children for seven affiliates.
  • Rating of Health Care metric in the Medicaid CAHPS survey for children for fifteen affiliates.
  • Rating of Personal Doctor metric in the Medicaid CAHPS survey for adults for nine affiliates.
  • Rating of Customer Service metric in the Medicaid CAHPS survey for adults for five affiliates.

Changing the Health Care Landscape

As a leader in value-based payment (VBP) programs, we are partnering with providers to change the health care landscape. We believe the most effective way to align quality and performance outcomes to optimize value is the overlay of our VBP programs with state-specific provider reimbursement strategies that focus on the evolving needs of the State and our members to create healthier communities.

About 58% of Amerigroup and its affiliated Medicaid health plans’ members are attributed to a primary care provider (PCP) or other provider who participates in one or more VBP models.

Since 2012, Amerigroup and its parent company’s affiliated health plans have reduced the number of opioid prescriptions filled by over 40%.

“Helping Members Get Back on Their Feet”

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What Our Members Say

“I am very thankful that my family can get the help they need to keep them healthy. We all greatly appreciate what Amerigroup does for us and are glad to be a part of the Amerigroup family.”

– Megan, Amerigroup member

Learn more about what we do

Children and Youth in Foster Care

Amerigroup cares for more than 80,000 children, adolescents and young adults in foster care, adoption assistance, and juvenile justice programs across the country.

Read More

Community Partnerships

Amerigroup seeks out new and better ways to improve member health outcomes, quality of life, and access to high quality, cost-efficient care and services.

Read More

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

CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).