Skip to main content

Quality matters

You deserve to get the highest quality care. So we work with your provider to make sure that happens. Together, we're committed to giving you the best health care experience possible. 

Questions?

Just call 1-888-348-2922 (TTY: 711). We’re here for you  24 hours a day, 7 days a week.

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:

 

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 reach your health goals. This includes:

 

  • Obstetrician/gynecologists (Ob/Gyns)
  • Pediatricians
  • Top hospitals
  • Community groups

 

HEDIS scores help us make sure we’re meeting our goals. You can scroll through the page to see our latest HEDIS results.  

Member satisfaction surveys

 

Your answers on our Consumer Assessment of Healthcare Providers and Systems (CAHPS®) surveys are private. We use the results to improve the way we take care of our members. You can see our survey results on this page. Or you can call Member Services to learn more. Just call 1-888-348-2922 (TTY: 711).

Recap of 2021 HEDIS and CAHPS results

 

 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.

 

Here are some of the 2021 HEDIS results:

 

Areas where we met our goals include:

 

  • Well care for children and adolescents
  • Childhood weight, nutrition and physical activity counseling
  • Annual dental visits
  • Blood pressure control in people with diabetes
  • Blood pressure control in people who do not have diabetes
  • Postpartum care visits
  • Early prenatal care visits

 

Areas where we did not meet our goals include:

 

  • Breast cancer screening for women
  • Cervical cancer screening for women
  • Lead screening in children
  • Diabetic eye exam

 

Areas where we did not meet goal but increased performance over prior year include:

 

  • Immunization for adolescents
  • Childhood immunizations

 

We also conduct a member satisfaction survey each year. The survey is called CAHPS. There is an adult survey and a child survey. The results from the survey help us:

 

  • Get feedback from members
  • Learn more about our members’ needs
  • Compare our service to other health care plans
  • Find ways to improve

 

Here are some of the 2021 CAHPS survey results

 

Areas where we met our goals on both surveys:

 

  • Getting needed care
  • Getting care quickly

 

Areas where we did not meet our goals:

 

  • Rating of personal doctor
  • Rating of health plan (child survey)
  • Rating of health care (child survey)
  • Rating of specialist doctor (child survey)
  • Coordination of care (child survey)
  • Customer service (child survey)

 

We will continue to work hard to make sure you get the best health care and service!

 

Your voice matters

 

If you get a member satisfaction survey, please take the time to complete it. We do our best to earn the highest scores (9 or 10) from our members. If you are not happy with your health care or service, please let us know. Call Member Services at  1-888-348-2922 (TTY: 711).

Our goals and objectives

Our goals and objectives

The Quality Improvement Program includes these goals:

 

  • Promote and build quality into the daily operations and policies of the health plan.
  • Continually check and assess your needs, care and services to ensure you’re getting quality care at the right time.
  • Find areas for improvement and act on them.
  • Encourage patient safety through seasonal communications to you (for example, flu mailers).
  • Ensure we meet or exceed the highest quality by following local, state and federal regulatory requirements and accreditation standards.
  • Provide support for the things that affect health, like rides, food and housing support.

Our services

Our services

The program provides many services, which include:

 

  • Offering extra benefits to encourage wellness, including a preventive care rewards program
  • Sending you helpful postcards and newsletters about your health
  • Reviewing primary care provider offices to make sure they meet state standards
  • Reviewing the quality of our services
  • Reminding you and your provider about preventive health care
  • Measuring your satisfaction with your provider and health care services
  • Scanning phone calls to ensure that we answer your call quickly and that you get the correct info
  • Working with your providers to ensure they get all the info they need from us to provide you with quality care
  • Offering health programs, including info about chronic illnesses and one-on-one support for social determinants of health (conditions in the places where you live, learn, work, and play that affect your health)

These are just some of our quality services. To learn more about them, call Member Services at 1-888-348-2922 (TTY: 711). You can also ask for a written description of our Quality Improvement Program.

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).