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Providing you with quality service
Providing you with quality service
Making sure you get the highest quality care when you need it is our goal. We partner with local providers who understand your needs. And the National Committee for Quality Assurance (NCQA) continues to accredit us. This is because we score high on:
- Clinical quality surveys
- Member satisfaction surveys
- NCQA surveys
Healthcare Effectiveness Data and Information Set (HEDIS®) scores
We want to improve access to quality health care for our members. You have a large network of providers to help you be as healthy as you can be. This includes:
HEDIS scores help us make sure we’re meeting our goals.
What is HEDIS?
HEDIS is one of health care’s most widely used performance improvement tools. HEDIS measurement allows consumers to compare health plan performance to other plans and to national or regional benchmarks. We use these measurements to evaluate the quality of the care and services given to our members and to track year-to-year performance. HEDIS is one component of NCQA's accreditation process required by state regulators.
HEDIS includes more than 90 measures across 6 areas of care, including:
Effectiveness of care
Access/availability of care
Experience of care
Utilization and risk adjusted utilization
Health plan descriptive information
Measures reported using electronic clinical data systems
You can find our HEDIS scores and compare with other health plans on the Florida Health Finder website.
You can also learn more about HEDIS on the NCQA website.
Member satisfaction surveys
We want you to be happy with our services and the care you receive from our providers. We use surveys to ask members (or in some cases, their families) about their experiences with health care services in different settings. We use the results of those surveys to improve the ways we take care of our members.
The Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey
The CAHPS survey is what we use to collect data about our members’ experience. This survey asks questions that focus on matters that our members find important. It tells us how they rank our health plan, our operations, our healthcare providers, including doctors, hospitals, physician practices and other healthcare providers and facilities.
CAHPS also asks about experiences with other aspects of health care, including getting needed care, getting care quickly, how well doctors communicate, health plan customer service and rating of health plan.
The CAHPS survey is another component of NCQA's accreditation process required by state regulators. NCQA publishes Health Plan Ratings each year. They rate all the health plans on a scale of 0 to 5 (0 is lowest) in .5 increments. You can find our ranking and other health plans on the NCQA website.
Note: Your answers on our CAHPS surveys are private. You can learn more about CAHPS on the NCQA website. Or you can contact us.
Each year, we report our HEDIS and CAHPS survey results to the state agencies and to NCQA. The Florida agencies and NCQA publish an annual report card. The rankings are shown with stars.
To see our latest HEDIS and CAHPS survey results, you can check our report card on the NCQA website.
Aetna Better Health of Florida report card
To see all results, including those for other Medicaid plans, just visit the Florida Health Finder website.
Your voice matters
If you get a member satisfaction survey, be sure to take the time to complete it. We do our best to earn the highest scores (9 or 10) from our members. If you’re not happy with your health care or service, we want to know. Just contact us.
We work hard to make sure you get the best health care and service. Each year, we look at how well we are doing. We set goals for care and service. If we don’t reach our goals, we make a plan to help us improve and reach our goals in the future.
We use HEDIS to measure if our members are getting good care. HEDIS is used across the country to compare health plans.
Adolescent well care
Childhood weight and nutritional counseling
Child and adolescent immunizations
Lead screening in children
Timely prenatal and postpartum care
Management of complex conditions, such as high blood pressure, diabetes and asthma
Breast and cervical cancer screening
Care of members with diabetes (A1c testing, annual eye exam, etc.)
Follow-up after hospitalization for mental illness or substance abuse
Follow-up care for children prescribed ADHD medication
Treatment for depression
Get feedback from members
Learn more about our members’ needs
Compare our service to other health care plans
Find ways to improve
Overall health care
Getting needed care quickly and easily
Specialist seen most often
How well doctors communicate
Customer Service at Aetna Better Health of Florida
Aetna Better Health of Florida as a whole
Our goals and objectives
Our goals and objectives
Our goal is to help you take care of your health and get the best care and services. The Quality Improvement (QI) Program helps us to make sure that our services meet high standards for safety and quality. We look at ways to better members’:
Access to doctors
We also always look for ways to make our services better. We do that by:
Measuring the quality and effectiveness of care and services
Making sure we use the best ways to check our services
Having qualified, competent and knowledgeable staff
Focusing on important problem areas
Being aware of our members’ culture and language needs
Making sure that we meet state and federal laws
Meeting all requirements of health care accreditation
Making sure we have a good network of doctors and hospitals
Making sure doctors and staff keep member info private
Every year we review our QI Program to be sure it meets guidelines. We look for ways to improve. This helps us make the QI Program better for next year.
Want to learn more about the QI Program? Just contact us.
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).