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.