2015 Medicare CAHPS At-A-Glance Report

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "2015 Medicare CAHPS At-A-Glance Report"

Transcription

1 2015 Medicare CAHPS At-A-Glance Report Advantage by Bridgeway Health Solutions CMS MA PD Contract: H5590 Project Number(s): Current data as of: 07/01/ Evergreen Boulevard Suite 100, Duluth, Georgia 30096

2 2015 At-A-Glance Report for Advantage by Bridgeway Health Solutions 1. Executive Summary SPH Analytics (SPHA), a Centers for Medicare and Medicaid Services (CMS) approved vendor and a National Committee for Quality Assurance (NCQA) Certified Healthcare Effectiveness Data and Information Set (HEDIS )¹ Survey Vendor, was selected by Advantage by Bridgeway Health Solutions to conduct its 2015 Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS ) Survey. This At-A-Glance report is designed to give you a summary view of those Medicare CAHPS results. SPHA collected 217 valid surveys from a sample size of 1016 provided by CMS. Results were collected from March through June of 2015, yielding a response rate of 23.4%. Topics included in the include: Throughout this report, results are shown as scaled mean scores, the same method that CMS uses to calculate Star scores.² It is important to note that these results are not case-mix adjusted and therefore will not match the results you receive from CMS. Since results are not case-mix adjusted, they should only be used for quality improvement purposes, not for estimating Star Ratings and/or bonus payments. Additionally, the measures and methodology used are reflective of the 2015 Star calculations. Composites Getting Needed Care Getting Care Quickly Doctors Who Communicate Well Care Coordination Health Plan Customer Service Getting Needed Prescription Drugs Getting Information About Prescription Drug Coverage and Cost Provider and Plan Ratings Other Single-Item Measures The Getting Needed Care composite measures member experiences when attempting to get care from doctors and specialists in the last six months (Questions 35 and 40). The Getting Care Quickly composite measures member experiences with receiving care and getting appointments in a reasonable amount of time (Questions 4, 6 and 8). The Doctors Who Communicate Well composite includes four questions measuring how well providers listen and explain, listen carefully to members, show respect for what members have to say, and whether they spend enough time with members (Questions 15 through 18). As of the 2012 Star Ratings, CMS is no longer including this composite in the Star Ratings. ¹ HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). ² The contract score is the mean score converted to a 100-point scale. Some questions do not lend themselves to a scaled mean score calculation. For these questions, the value is the percentage of members responding Yes. Note: Results in SPH Analytics reporting do not represent CMS official results. SPH Analytics 2015 At-A-Glance Report 1-1

3 2015 At-A-Glance Report for Advantage by Bridgeway Health Solutions The Care Coordination composite asks members to report whether their doctor had medical records or other information about their care and whether the doctor talked about prescription medicines. This composite also contains questions asking members if they got help managing their care and if the doctor was informed and up-to-date about their specialty care. Additionally, this composite evaluates whether the member s personal doctor s office followed up to give them test results and if they got the test results as soon as they needed (Questions 20, 22-23, 25, 31, and 38). When calculating this composite, Personal doctor's office followed up to give you test results (Question 22) and Got test results as soon as you needed (Question 23) are combined according to CMS conventions. This combined item measure is then averaged with the remaining composite questions in order to form the overall Care Coordination composite. The Health Plan Customer Service composite asks members to rate the ease of getting information or help from customer service, how often they were treated with courtesy and respect by customer service staff, and how often health plan forms were easy to fill out (Questions 42, 43, and 45). The Getting Needed Prescription Drugs composite measures the ease of using the health plan to get prescribed medicines, to fill prescriptions at the local pharmacy and to fill prescriptions by mail (Questions 69, 71, and 73). When calculating this composite, the Ease of using health plan to fill prescriptions at local pharmacy (Question 71) and the Ease of using health plan to fill prescriptions by mail (Question 73) measures are weighted and combined according to CMS conventions. This combined measure is then averaged with the Ease of using health plan to get prescribed medicines (Question 69) in order to form the overall Getting Needed Prescription Drugs composite. The Getting Information from the Plan About Prescription Drug Coverage and Cost composite measures how often members got the information or help they needed from the prescription drug plan customer service, how often members were treated with courtesy and respect by the prescription drug plan customer service staff, the ease of getting information about which medications were covered, and the ease of getting information about the cost of medications (Questions 58, 59, 61, and 63). As of the 2013 Star Ratings, CMS is no longer including this composite in the Star Ratings. Ratings There are five questions with responses scaled 0 to 10 in the Medicare CAHPS survey: Rating of Health Care (Q12), Rating of Personal Doctor (Q19), Rating of Specialist (Q37), Rating of Health Plan (Q46), and Rating of Drug Plan (Q74) where zero represents worst possible and 10 represents best possible. Note: Results in SPH Analytics reporting do not represent CMS official results. SPH Analytics 2015 At-A-Glance Report 1-2

4 2015 At-A-Glance Report for Advantage by Bridgeway Health Solutions Other Single-Item Measures The Annual Flu Vaccine measure is the percentage of members who received an influenza vaccination since July 1, The score for the Annual Flu Vaccine measure is the proportion of respondents who responded Yes to the question, Have you had a flu shot since July 1, 2014 (Question 85). The Willingness to Recommend Plan for Drug Coverage question asks members if they would recommend their prescription drug plan to other people like themselves (Question 75). The Delaying or Not Filling a Prescription question is the percentage of respondents that said Yes when asked if they delayed or didn t fill a prescription because they felt they couldn t afford it (Question 82). The After Hours Call question is the percentage of members that phoned a doctor s office or clinic with a medical question after regular office hours (Question 9). The Answer as Soon as Needed question evaluates how often members got an answer to their medical question as soon as they needed when they phoned a doctor s office or clinic after regular office hours (Question 10). The Pneumonia Vaccine measure is the percentage of members who reported ever having received a pneumococcal vaccine. The score for the Pneumonia Vaccine is the proportion of respondents who responded Yes to the question, Have you ever had a pneumonia shot? This shot is usually given only once or twice in a person s lifetime and is different from the flu shot. It is also called the pneumococcal vaccine (Question 86). Question 47 is comprised of three parts that measure whether or not anyone from a doctor s office or the member s health plan contacted the member to remind them about appointments for tests or treatment, to remind them to get a flu shot or other immunization or to remind them about screening tests such as breast cancer or colorectal cancer screening (Questions 47A, 47B, and 47C). The percentage of members who reported Yes to these questions is displayed. Question 68 includes two parts that ask members if anyone from a doctor s office, pharmacy or prescription drug plan contacted them to make sure they filled or refilled a prescription or to make sure they were taking medications as directed (Questions 68A and 68B). The percentage of members who reported Yes to these questions is displayed. The Complaint Resolution measure allows respondents to report how satisfied they are with how their health plan handled their complaint, regardless of whether they agreed or disagreed with the final outcome (Question 54). The Doctor Used a Computer/Handheld Device question is the percentage of members who reported that their personal doctor used a computer or handheld device during an office visit (Question 26). Note: Results in SPH Analytics reporting do not represent CMS official results. SPH Analytics 2015 At-A-Glance Report 1-3

5 2015 At-A-Glance Report for Advantage by Bridgeway Health Solutions The Doctor s Use of Computer/Handheld Device was Helpful question asks members to evaluate whether or not they thought their personal doctor s use of a computer or handheld device was helpful to them (Question 27). The Doctor s Use of Computer/Handheld Device Made it Easier to Talk to Him/Her question allows members to assess whether their doctor s use of a computer or handheld device made it harder or easier for the member to speak with the doctor (Question 28). The Received Mail Order Medicines Not Requested question is the percentage of members who reported that they received a mail order medicine that they did not request (Question 83). Note: Results in SPH Analytics reporting do not represent CMS official results. SPH Analytics 2015 At-A-Glance Report 1-4

6 Profile of Survey Respondents Advantage by Bridgeway Health Solutions 2015 Medicare CAHPS At-A-Glance Results MA PD Contract # H5590 Sample Size 1016 Total Survey Returns 217 Response Rate 23.4% KEY: Current Year Trend Year One 2014 CMS National Data Benchmark * Health Status and Mental Health Status are defined by survey respondent. Note 1: The 2014 CMS National Data benchmark consists of 451,561 respondents from plans that submitted data to CMS in Note 2: Significance Testing - " " denotes a significantly lower 2015 percentage when compared to 2014 or the benchmark. " " denotes a significantly higher 2015 percentage when compared to 2014 or the benchmark. No arrow denotes that there was no significant difference between the percentages or that there was insufficient sample size to conduct the statistical test. All significance testing is performed at the 95% significance level. Note 3: Age and Gender were determined by database information in For this reason, a CMS benchmark is not available. Low Income Subsidy and Medicaid Dual Eligible were not evaluated prior to 2015; therefore, benchmark and trend data are unavailable for comparison. Note 4: Results in SPH Analytics reporting do not represent CMS official results. Note 5: "NA" represents results that have cell sizes of 10 or less. These results have been suppressed according to CMS rules. See Glossary of Terms for more information. SPH Analytics 2015 At-A-Glance Report Chart 1

7 Advantage by Bridgeway Health Solutions Star Domains: Scaled Mean Scores Composites, Ratings, and Key Questions Valid n Contract Score* 2015 SPH Analytics Book of Business DOMAIN: Member Experience with Health Plan Benchmarks** 2014 CMS National Data Getting Needed Care Q35 Ease of getting appointment with a specialist Q40 Getting care, tests, or treatments necessary Getting Care Quickly Q4 Obtaining needed care right away Q6 Obtaining care when needed, not when needed right away Q8 Saw person came to see within 15 minutes of appointment time Health Plan Customer Service Q42 Getting information/help from customer service Q43 Treated with courtesy and respect by customer service staff Q45 Health plan forms easy to fill out Care Coordination*** X Q22 Personal doctor's office followed up to give you test results Q23 Got test results as soon as you needed Combined Item - Test Results X Q20 Doctor had medical records or other information about your care Q25 Doctor talked about prescription medicines Q31 Got help managing care Q38 Doctor informed and up-to-date about specialty care Q46 Rating of Health Plan Q12 Rating of Health Care DOMAIN: Member Experience with Drug Plan Getting Needed Prescription Drugs**** X Q69 Ease of using health plan to get prescribed medicines Combined Local Pharmacy and Mail X Q71 Ease of using health plan to fill prescriptions at local pharmacy Q73 Ease of using health plan to fill prescriptions by mail Q74 Rating of Drug Plan DOMAIN: Staying Healthy - Screenings, Tests, and Vaccines Q85 Annual Flu Vaccine % 70.1% 72.9% OTHER MEASURES 2015 Medicare CAHPS At-A-Glance Results MA PD Contract # H5590 Doctors Who Communicate Well Q15 Doctors explaining things in an understandable way Q16 Doctors listening carefully to you Q17 Doctors showing respect for what you had to say Q18 Doctors spending enough time with you Getting Info About Rx Drug Coverage and Cost Q58 Getting information/help from PDP customer service Q59 Treated with courtesy and respect by PDP customer service staff Q61 Getting information needed about which medications covered Q63 Getting information needed about cost of medications Q19 Rating of Personal Doctor Q37 Rating of Specialist * The contract score is the mean score converted to a 100-point scale, with the exception of the Annual Flu Vaccine, Delaying or Not Filling a Prescription, After Hours Call, Pneumonia Vaccine, Contact: Appointments for Tests and Treatment Reminder, Contact: Flu Shot or Other Immunization Reminder, Contact: Screening Tests Reminder, Contact: Filled or Refilled a Prescription, Contact: Taking Medications as Directed, Doctor used a Computer/Handheld Device, and Received Mail Order Medicines Not Requested questions. For these questions, the value is the percentage of members responding "Yes." See Glossary of Terms for more information. ** The 2015 SPH Analytics Book of Business consists of 102 MA-PD and MA-Only contracts that conducted the Medicare CAHPS survey with SPH Analytics in The 2014 CMS benchmark consists of 451,561 respondents from contracts that submitted data to CMS in *** The Care Coordination composite is calculated by taking the average of those questions shaded in light blue. Please note that there is no CMS benchmark available for this composite. Furthermore, the 'Combined Item - Test Results' score is calculated by taking the average of 'Personal doctor's office followed up to give you test results' and 'Got test results as soon as you needed.' **** The Getting Needed Prescription Drugs composite is calculated by taking the average of the 'Ease of using health plan to get prescribed medicines' question and the weighted 'Combined Local Pharmacy and Mail' composite (those measures shaded light blue). There is no CMS benchmark available for this measure. Note 1: Significance Testing - Cells highlighted in red denote 2015 contract score is significantly lower when compared to benchmark data; Cells highlighted in green denote 2015 contract score is significantly higher when compared to benchmark data; No shading denotes that there was no significant difference between the scores or that there was insufficient sample size to conduct the statistical test. All significance testing is performed at the 95% significance level. Significance testing of composites should be used with caution as a rough guideline, since the test procedure is approximate. Note 2: "NA" represents results that have cell sizes of 10 or less. These results have been suppressed according to CMS rules. See Glossary of Terms for more information. Note 3: Results in SPH Analytics reporting do not represent CMS official results. X These values cannot be calculated with available data. SPH Analytics 2015 At-A-Glance Report Chart 2-1

8 Advantage by Bridgeway Health Solutions Star Domains: Scaled Mean Scores Single-Items Q75 Willingness to Recommend Plan for Drug Coverage Q82 Delaying or Not Filling a Prescription % 12.8% 12.2% Q9 After Hours Call % 11.7% 9.9% Q10 Answer as Soon as Needed Q86 Pneumonia Vaccine - All Respondents % 66.2% 70.3% Q47A Contact: Appointments for Tests and Treatment Reminder % 57.6% 59.5% Q47B Contact: Flu Shot or Other Immunization Reminder % 40.9% 46.1% Q47C Contact: Screening Tests Reminder % 37.9% 39.4% Q68A Contact: Filled or Refilled a Prescription % 36.4% 37.6% Q68B Contact: Taking Medications as Directed % 25.2% 22.8% Q54 Complaint Resolution Q26 Doctor used a Computer/Handheld Device % 85.2% 82.8% Q27 Doctor's use of Computer/Handheld Device was Helpful Q28 Doctor's use of Computer/Handheld Device Made it Easier to Talk to Him/Her 2015 Medicare CAHPS At-A-Glance Results MA PD Contract # H Q83 Received Mail Order Medicines Not Requested 200 NA 1.4% 1.4% * The contract score is the mean score converted to a 100-point scale, with the exception of the Annual Flu Vaccine, Delaying or Not Filling a Prescription, After Hours Call, Pneumonia Vaccine, Contact: Appointments for Tests and Treatment Reminder, Contact: Flu Shot or Other Immunization Reminder, Contact: Screening Tests Reminder, Contact: Filled or Refilled a Prescription, Contact: Taking Medications as Directed, Doctor used a Computer/Handheld Device, and Received Mail Order Medicines Not Requested questions. For these questions, the value is the percentage of members responding "Yes." See Glossary of Terms for more information. ** The 2015 SPH Analytics Book of Business consists of 102 MA-PD and MA-Only contracts that conducted the Medicare CAHPS survey with SPH Analytics in The 2014 CMS benchmark consists of 451,561 respondents from contracts that submitted data to CMS in *** The Care Coordination composite is calculated by taking the average of those questions shaded in light blue. Please note that there is no CMS benchmark available for this composite. Furthermore, the 'Combined Item - Test Results' score is calculated by taking the average of 'Personal doctor's office followed up to give you test results' and 'Got test results as soon as you needed.' **** The Getting Needed Prescription Drugs composite is calculated by taking the average of the 'Ease of using health plan to get prescribed medicines' question and the weighted 'Combined Local Pharmacy and Mail' composite (those measures shaded light blue). There is no CMS benchmark available for this measure. Note 1: Significance Testing - Cells highlighted in red denote 2015 contract score is significantly lower when compared to benchmark data; Cells highlighted in green denote 2015 contract score is significantly higher when compared to benchmark data; No shading denotes that there was no significant difference between the scores or that there was insufficient sample size to conduct the statistical test. All significance testing is performed at the 95% significance level. Significance testing of composites should be used with caution as a rough guideline, since the test procedure is approximate. Note 2: "NA" represents results that have cell sizes of 10 or less. These results have been suppressed according to CMS rules. See Glossary of Terms for more information. Note 3: Results in SPH Analytics reporting do not represent CMS official results. X These values cannot be calculated with available data. SPH Analytics 2015 At-A-Glance Report Chart 2-2

9 Advantage by Bridgeway Health Solutions Trend Comparisons 2015 Medicare CAHPS At-A-Glance Results MA PD Contract # H Composites, Ratings, and Key Questions Valid n Contract Score* Valid n Contract Score* DOMAIN: Member Experience with Health Plan Getting Needed Care Q35 Ease of getting appointment with a specialist Q40 Getting care, tests, or treatments necessary Getting Care Quickly Q4 Obtaining needed care right away Q6 Obtaining care when needed, not when needed right away Q8 Saw person came to see within 15 minutes of appointment time Health Plan Customer Service Q42 Getting information/help from customer service Q43 Treated with courtesy and respect by customer service staff Q45 Health plan forms easy to fill out Care Coordination** Q22 Personal doctor's office followed up to give you test results Q23 Got test results as soon as you needed Combined Item - Test Results Q20 Doctor had medical records or other information about your care Q25 Doctor talked about prescription medicines Q31 Got help managing care Q38 Doctor informed and up-to-date about specialty care Q46 Rating of Health Plan Q12 Rating of Health Care DOMAIN: Member Experience with Drug Plan Getting Needed Prescription Drugs*** 86.7 NA Q69 Ease of using health plan to get prescribed medicines Combined Local Pharmacy and Mail NA NA Q71 Ease of using health plan to fill prescriptions at local pharmacy Q73 Ease of using health plan to fill prescriptions by mail NA NA Q74 Rating of Drug Plan DOMAIN: Staying Healthy - Screenings, Tests, and Vaccines Q85 Annual Flu Vaccine % % OTHER MEASURES Doctors Who Communicate Well Q15 Doctors explaining things in an understandable way Q16 Doctors listening carefully to you Q17 Doctors showing respect for what you had to say Q18 Doctors spending enough time with you Getting Info About Rx Drug Coverage and Cost Q58 Getting information/help from PDP customer service Q59 Treated with courtesy and respect by PDP customer service staff Q61 Getting information needed about which medications covered Q63 Getting information needed about cost of medications Q19 Rating of Personal Doctor Q37 Rating of Specialist * The contract score is the mean score converted to a 100-point scale, with the exception of the Annual Flu Vaccine, Delaying or Not Filling a Prescription, After Hours Call, Pneumonia Vaccine, Contact: Appointments for Tests and Treatment Reminder, Contact: Flu Shot or Other Immunization Reminder, Contact: Screening Tests Reminder, Contact: Filled or Refilled a Prescription, Contact: Taking Medications as Directed, Doctor used a Computer/Handheld Device, and Received Mail Order Medicines Not Requested questions. For these questions, the value is the percentage of members responding "Yes." See Glossary of Terms for more information. ** The Care Coordination composite is calculated by taking the average of those questions shaded in light blue. Furthermore, the 'Combined Item - Test Results' score is calculated by taking the average of 'Personal doctor's office followed up to give you test results' and 'Got test results as soon as you needed.' *** The Getting Needed Prescription Drugs composite is calculated by taking the average of the 'Ease of using health plan to get prescribed medicines' question and the weighted 'Combined Local Pharmacy and Mail' composite (those measures shaded light blue). Note 1: Significance Testing - Cells highlighted in red denote 2015 contract score is significantly lower when compared to trend data; Cells highlighted in green denote 2015 contract score is significantly higher when compared to trend data; No shading denotes that there was no significant difference between the scores or that there was insufficient sample size to conduct the statistical test. All significance testing is performed at the 95% significance level. Significance testing of composites should be used with caution as a rough guideline, since the test procedure is approximate. Note 2: "NA" represents results that have cell sizes of 10 or less. These results have been suppressed according to CMS rules. See Glossary of Terms for more information. Note 3: Results in SPH Analytics reporting do not represent CMS official results. SPH Analytics 2015 At-A-Glance Report Chart 3-1

10 Advantage by Bridgeway Health Solutions 2015 Medicare CAHPS At-A-Glance Results Trend Comparisons MA PD Contract # H5590 Single-Items Q75 Willingness to Recommend Plan for Drug Coverage Q82 Delaying or Not Filling a Prescription % % Q9 After Hours Call % % Q10 Answer as Soon as Needed Q86 Pneumonia Vaccine - All Respondents % % Q47A Contact: Appointments for Tests and Treatment Reminder % % Q47B Contact: Flu Shot or Other Immunization Reminder % % Q47C Contact: Screening Tests Reminder % % Q68A Contact: Filled or Refilled a Prescription % % Q68B Contact: Taking Medications as Directed % % Q54 Complaint Resolution Q26 Doctor used a Computer/Handheld Device % % Q27 Doctor's use of Computer/Handheld Device was Helpful Q28 Doctor's use of Computer/Handheld Device Made it Easier to Talk to Him/Her Q83 Received Mail Order Medicines Not Requested 200 NA 116 NA * The contract score is the mean score converted to a 100-point scale, with the exception of the Annual Flu Vaccine, Delaying or Not Filling a Prescription, After Hours Call, Pneumonia Vaccine, Contact: Appointments for Tests and Treatment Reminder, Contact: Flu Shot or Other Immunization Reminder, Contact: Screening Tests Reminder, Contact: Filled or Refilled a Prescription, Contact: Taking Medications as Directed, Doctor used a Computer/Handheld Device, and Received Mail Order Medicines Not Requested questions. For these questions, the value is the percentage of members responding "Yes." See Glossary of Terms for more information. ** The Care Coordination composite is calculated by taking the average of those questions shaded in light blue. Furthermore, the 'Combined Item - Test Results' score is calculated by taking the average of 'Personal doctor's office followed up to give you test results' and 'Got test results as soon as you needed.' *** The Getting Needed Prescription Drugs composite is calculated by taking the average of the 'Ease of using health plan to get prescribed medicines' question and the weighted 'Combined Local Pharmacy and Mail' composite (those measures shaded light blue). Note 1: Significance Testing - Cells highlighted in red denote 2015 contract score is significantly lower when compared to trend data; Cells highlighted in green denote 2015 contract score is significantly higher when compared to trend data; No shading denotes that there was no significant difference between the scores or that there was insufficient sample size to conduct the statistical test. All significance testing is performed at the 95% significance level. Significance testing of composites should be used with caution as a rough guideline, since the test procedure is approximate. Note 2: "NA" represents results that have cell sizes of 10 or less. These results have been suppressed according to CMS rules. See Glossary of Terms for more information. Note 3: Results in SPH Analytics reporting do not represent CMS official results. SPH Analytics 2015 At-A-Glance Report Chart 3-2

11 2015 At-A-Glance Report for Advantage by Bridgeway Health Solutions 2-1. Glossary of Terms Attributes are the questions that relate to a specific service area or composite as defined by CMS. Cell Size Suppression is required by CMS in order to protect the privacy of the members responding to the survey. When 10 or fewer people respond in any response option, those results are suppressed by SPHA and are reflected by an NA. Composites are the average of the scaled means of attributes within a given service area as specified by CMS or SPHA. CMS National Data (calculated at the respondent-level) is a collection of respondent-level data from contracts conducting Medicare CAHPS with CMS in The CMS National Data consists of 451,561 respondents that completed an MA-PD or MA Only survey in The scores shown in this report reflect the scores for all respondents. Domains refer to the main topic areas analyzed by CMS in 2014 to produce the 2015 Star Ratings. These are subject to change for this year s Star Ratings. Rating questions use a scale of 0 to 10 for assessing overall experience (doctor, specialist, health care, health plan and prescription drug plan) with zero being the worst and 10 being the best. Scaled Mean Scores are a conversion of standard mean scores to a 100-point scale in order to replicate the CMS scoring methodology. It is important to note that the results provided by SPHA are NOT CASE-MIX ADJUSTED and will not match the results you receive from CMS. Significance test is a test to determine if an observed difference is too large to have occurred by chance alone. Star Ratings are a five-star rating system calculated each year by CMS for Medicare Advantage contracts. Ratings are based on data obtained from four sources: the Medicare CAHPS survey, the Health Outcomes Survey (HOS), CMS Administrative data, and the Health Effectiveness Data and Information Set (HEDIS ). The SPHA Book of Business (calculated on a contract-level) consists of all Medicare Advantage contracts that conducted an MA-PD or MA Only survey with SPHA. In 2015, there were 102 contracts included in the Book of Business. Note: Results in SPH Analytics reporting do not represent CMS official results. SPH Analytics 2015 At-A-Glance Report 2-0

2015 Medicaid Child CAHPS 5.0H. At-A-Glance Report

2015 Medicaid Child CAHPS 5.0H. At-A-Glance Report 2015 Medicaid Child CAHPS 5.0H At-A-Glance Report Health Partners Plans Project Number(s): 5103676 Current data as of: 06/09/2015 1965 Evergreen Boulevard Suite 100, Duluth, Georgia 30096 2015 At-A-Glance

More information

The Centers for Medicare & Medicaid Services (CMS) strives to make information available to all. Nevertheless, portions of our files including

The Centers for Medicare & Medicaid Services (CMS) strives to make information available to all. Nevertheless, portions of our files including The Centers for Medicare & Medicaid Services (CMS) strives to make information available to all. Nevertheless, portions of our files including charts, tables, and graphics may be difficult to read using

More information

MEASURE C01: Breast Cancer Screening. MEASURE C02: Colorectal Cancer Screening. MEASURE C07: Adult BMI Assessment

MEASURE C01: Breast Cancer Screening. MEASURE C02: Colorectal Cancer Screening. MEASURE C07: Adult BMI Assessment HEDIS: THESE ARE THE S WE CAN HAVE THE GREATEST IMPACT ON! Healthcare Effectiveness Data and Information Set. Measures health plan performance on health care and service. HEDIS data are collected through

More information

PBM s: Helping to Improve MA-PD Star Scores. James Brehany PharmD, PA-C, JD Associate Vice President, Pharmacy Services PerformRx

PBM s: Helping to Improve MA-PD Star Scores. James Brehany PharmD, PA-C, JD Associate Vice President, Pharmacy Services PerformRx PBM s: Helping to Improve MA-PD Star Scores James Brehany PharmD, PA-C, JD Associate Vice President, Pharmacy Services PerformRx CMS Star Rating System Instituted in 2008 Applicable to MA plans, MA-PD

More information

Chapter 5: Quality Management

Chapter 5: Quality Management 5 Quality Management OVERVIEW Health Choice Generations Quality Management/Performance Improvement (QM/PI) Program, under the leadership of the Chief Medical Officer with the Quality Management Committee,

More information

Enrollee Satisfaction Survey System: Options and Considerations. April 26, 2013

Enrollee Satisfaction Survey System: Options and Considerations. April 26, 2013 Enrollee Satisfaction Survey System: Options and Considerations April 26, 2013 Under the Affordable Care Act (ACA), Exchanges must administer and report on an enrollee satisfaction survey 1. The U.S. Department

More information

2015 Michigan Department of Health and Human Services Adult Medicaid Health Plan CAHPS Report

2015 Michigan Department of Health and Human Services Adult Medicaid Health Plan CAHPS Report 2015 State of Michigan Department of Health and Human Services 2015 Michigan Department of Health and Human Services Adult Medicaid Health Plan CAHPS Report September 2015 Draft Draft 3133 East Camelback

More information

6 strategies to improve HEDIS scores and Star ratings

6 strategies to improve HEDIS scores and Star ratings Transforming healthcare through innovative digital engagement 6 strategies to improve HEDIS scores and Star ratings By Chuck Rolfsen, Chief Revenue Officer, Healthx Proven strategies to help move the needle

More information

Quality Management (QM) Program Goals and Objectives

Quality Management (QM) Program Goals and Objectives Quality Management (QM) Program Goals and Objectives The goals and objectives of the QM Program are: To improve the quality of medical and behavioral health care and service provided to Members through

More information

Quality Management (QM) Program Goals and Objectives The goals and objectives of the QM Program are: To improve the quality of medical and behavioral

Quality Management (QM) Program Goals and Objectives The goals and objectives of the QM Program are: To improve the quality of medical and behavioral Quality Management (QM) Program Goals and Objectives The goals and objectives of the QM Program are: To improve the quality of medical and behavioral health care and service provided to Members through

More information

THE MYERS GROUP MEDICARE CAHPS RESEARCH SERIES

THE MYERS GROUP MEDICARE CAHPS RESEARCH SERIES THE MYERS GROUP MEDICARE CAHPS RESEARCH SERIES Background Each year, CMS rates each Medicare Advantage plan using a five star rating system. While originally developed to provide members with the ability

More information

An Update on Medicare Parts C & D Performance Measures

An Update on Medicare Parts C & D Performance Measures An Update on Medicare Parts C & D Performance Measures CMS Spring Conference April 12 & 13, 2011 Liz Goldstein, Ph.D. Director, Division of Consumer Assessment & Plan Performance Vikki Oates, M.A.S Director,

More information

Appendix 1. CAHPS Health Plan Survey 4.0H Adult Questionnaire (Commercial)

Appendix 1. CAHPS Health Plan Survey 4.0H Adult Questionnaire (Commercial) Appendix CAHPS Health Plan Survey.0H Adult Questionnaire (Commercial) - HEDIS 0, Volume Appendix CAHPS.0H Adult Questionnaire (Commercial) - CAHPS.0H Adult Questionnaire (Commercial) SURVEY INSTRUCTIONS

More information

2014 Washington State Health Care Authority Adult Medicaid Health Plan CAHPS Report

2014 Washington State Health Care Authority Adult Medicaid Health Plan CAHPS Report State of Washington Health Care Authority 2014 Washington State Health Care Authority Adult Medicaid Health Plan CAHPS Report December 2014 3133 East Camelback Road, Suite 300 Phoenix, AZ 85016 Phone 602.264.6382

More information

HEDIS, STAR Performance Metrics. Sheila Linehan, RN,MPH, CPHQ Director of QM, Horizon BCBSNJ July 16, 2014

HEDIS, STAR Performance Metrics. Sheila Linehan, RN,MPH, CPHQ Director of QM, Horizon BCBSNJ July 16, 2014 HEDIS, STAR Performance Metrics Sheila Linehan, RN,MPH, CPHQ Director of QM, Horizon BCBSNJ July 16, 2014 Goals Discuss what HEDIS and Star Metrics are Discuss their impact on Health Plans Discuss their

More information

Covered California CAHPS Ratings Fall 2014 Scoring Health Plan s Historical CAHPS Results

Covered California CAHPS Ratings Fall 2014 Scoring Health Plan s Historical CAHPS Results Covered California CAHPS Ratings Fall 2014 Scoring Health Plan s Historical CAHPS Results Summary of Key Elements Covered California CAHPS Quality Rating System (QRS) is comprised of the following elements:

More information

Framework for Improving Medicare Plan Star Ratings

Framework for Improving Medicare Plan Star Ratings Framework for Improving Medicare Plan Star Ratings Designed by the Center of Medicaid and Medicare Services (CMS), the five-star rating system is a quality and performance scoring method used for certain

More information

Session 10 PD, STAR Rating Improvements, Maintenance, and Impossibilities. Moderator/Presenter: Greg Vincent Sgrosso, FSA, MAAA

Session 10 PD, STAR Rating Improvements, Maintenance, and Impossibilities. Moderator/Presenter: Greg Vincent Sgrosso, FSA, MAAA Session 10 PD, STAR Rating Improvements, Maintenance, and Impossibilities Moderator/Presenter: Greg Vincent Sgrosso, FSA, MAAA Presenter: Donna McDonald Medicare Advantage Star Rating Improvements, Maintenance

More information

Health Care Reform Update January 2012 MG76120 0212 LILLY USA, LLC. ALL RIGHTS RESERVED

Health Care Reform Update January 2012 MG76120 0212 LILLY USA, LLC. ALL RIGHTS RESERVED Health Care Reform Update January 2012 Disclaimer This presentation is for educational purposes only. It is not a complete analysis of the material contained herein. Before taking any action on the issues

More information

2015 HEDIS/CAHPS Effectiveness of Care Report for 2014 Service Measures Oregon, Idaho and Montana Commercial Business

2015 HEDIS/CAHPS Effectiveness of Care Report for 2014 Service Measures Oregon, Idaho and Montana Commercial Business 2015 HEDIS/CAHPS Effectiveness of Care Report for 2014 Service Measures Oregon, Idaho and Montana Commercial Business About HEDIS The Healthcare Effectiveness Data and Information Set (HEDIS 1 ) is a widely

More information

Medicare 2015 QI Program Evaluation

Medicare 2015 QI Program Evaluation Color Code: Red does not meet 5 star threshold, or target. Green meets or exceeds 5 star threshold/target. Improving or Maintaining Physical Health (HOS) Improving or Maintaining Mental Health (HOS) Diabetes

More information

FY 14-15 ADULT MEDICAID CLIENT SATISFACTION REPORT

FY 14-15 ADULT MEDICAID CLIENT SATISFACTION REPORT FY 14-15 ADULT MEDICAID CLIENT SATISFACTION REPORT September 2015 This report was produced by Health Services Advisory Group, Inc. for the Colorado Department of Policy & Financing. 3133 East Camelback

More information

Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Summit Health Plan of Florida

Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Summit Health Plan of Florida Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Summit Health Plan of Florida Medicare Quality Management Program Overview Quality Improvement (QI) Overview At Coventry, we

More information

Humana Physician Quality Rewards Program 2014

Humana Physician Quality Rewards Program 2014 Humana Physician Quality Rewards Program 2014 Medicare Name Date External Presentation 1430ALL0114 B Humana s Accountable Care Continuum Provider Quality Rewards HEDIS based quality metrics Clinical +

More information

2014 Ohio Medicaid Managed Care Program CAHPS Member Satisfaction Survey Methodology Report

2014 Ohio Medicaid Managed Care Program CAHPS Member Satisfaction Survey Methodology Report 2014 Ohio Medicaid Managed Care Program CAHPS Member Satisfaction Survey Methodology Report June 2015 3133 East Camelback Road, Suite 100 Phoenix, AZ 85016 Phone 602.264.6382 Fax 602.241.0757 TABLE OF

More information

HEDIS/CAHPS 101. August 13, 2012 Minnesota Measurement and Reporting Workgroup

HEDIS/CAHPS 101. August 13, 2012 Minnesota Measurement and Reporting Workgroup HEDIS/CAHPS 101 Minnesota Measurement and Reporting Workgroup Objectives Provide introduction to NCQA Identify HEDIS/CAHPS basics Discuss various components related to HEDIS/CAHPS usage, including State

More information

Bridging the Gap. Adult Immunizations: Benefit Design, Reimbursement Challenges and Billing Solutions

Bridging the Gap. Adult Immunizations: Benefit Design, Reimbursement Challenges and Billing Solutions Bridging the Gap between real time pharmacy claims and batch medical claims Adult Immunizations: Benefit Design, Reimbursement Challenges and Billing Solutions Introduction Provider Challenges Overcoming

More information

Results of the 2007 Consumer Assessment of Healthcare Providers and Systems (CAHPS ) for Medi-Cal Managed Care Health Plans

Results of the 2007 Consumer Assessment of Healthcare Providers and Systems (CAHPS ) for Medi-Cal Managed Care Health Plans Results of the Consumer Assessment of Healthcare Providers and Systems (CAHPS ) for Medi-Cal Managed Care Health Plans Prepared for: California Department of Health Care Services (DHCS) Prepared by: and

More information

8/14/2012 California Dual Demonstration DRAFT Quality Metrics

8/14/2012 California Dual Demonstration DRAFT Quality Metrics Stakeholder feedback is requested on the following: 1) metrics 69 through 94; and 2) withhold measures for years 1, 2, and 3. Steward/ 1 Antidepressant medication management Percentage of members 18 years

More information

STATEMENT OF JONATHAN BLUM ACTING PRINCIPAL DEPUTY ADMINISTRATOR AND DIRECTOR, CENTER FOR MEDICARE CENTERS FOR MEDICARE & MEDICAID SERVICES

STATEMENT OF JONATHAN BLUM ACTING PRINCIPAL DEPUTY ADMINISTRATOR AND DIRECTOR, CENTER FOR MEDICARE CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF JONATHAN BLUM ACTING PRINCIPAL DEPUTY ADMINISTRATOR AND DIRECTOR, CENTER FOR MEDICARE CENTERS FOR MEDICARE & MEDICAID SERVICES ON MEDICARE ADVANTAGE QUALITY BONUS DEMONSTRATION BEFORE THE

More information

2013 CAHPS Adult Medicaid Member Satisfaction Survey

2013 CAHPS Adult Medicaid Member Satisfaction Survey CAHPS Adult Medicaid Member Satisfaction Survey Oklahoma Health Care Authority July This document was developed through funding provided by the grant program outlined under the Catalog of Federal Domestic

More information

Trends in Part C & D Star Rating Measure Cut Points

Trends in Part C & D Star Rating Measure Cut Points Trends in Part C & D Star Rating Measure Cut Points Updated 11/18/2014 Document Change Log Previous Version Description of Change Revision Date - Initial release of the 2015 Trends in Part C & D Star Rating

More information

Appendix 1. CAHPS Health Plan Survey 5.0H Adult Questionnaire (Commercial)

Appendix 1. CAHPS Health Plan Survey 5.0H Adult Questionnaire (Commercial) Appendix 1 CAHPS Health Plan Survey 5.0H Adult Questionnaire (Commercial) 1-2 Appendix 1 CAHPS 5.0H Adult Questionnaire (Commercial) 1-3 CAHPS 5.0H Adult Questionnaire (Commercial) SURVEY INSTRUCTIONS

More information

TECHNICAL ASSISTANCE BRIEF. Guidance for Conducting the Consumer Assessment of Healthcare Providers and Systems (CAHPS ) 5.

TECHNICAL ASSISTANCE BRIEF. Guidance for Conducting the Consumer Assessment of Healthcare Providers and Systems (CAHPS ) 5. Initial Core Set of Children s Health Care Quality Measures TECHNICAL ASSISTANCE BRIEF Number 3 December 202 Guidance for Conducting the Consumer Assessment of Healthcare Providers and Systems (CAHPS )

More information

Medicare 2013 QI Program Evaluation

Medicare 2013 QI Program Evaluation #1 Priority Measures Diabetes Medication Adherence D 3 69% 71% High Risk Meds in the Elderly D 3 8% 3% Sleep medications were added to the measure after the 2013 formulary was accepted. A number of high

More information

PATIENTS PERSPECTIVES ON HEALTH CARE IN THE UNITED STATES A LOOK AT SEVEN STATES & THE NATION

PATIENTS PERSPECTIVES ON HEALTH CARE IN THE UNITED STATES A LOOK AT SEVEN STATES & THE NATION PATIENTS PERSPECTIVES ON HEALTH CARE IN THE UNITED STATES A LOOK AT SEVEN STATES & THE NATION February 2016 INTRODUCTION The landscape and experience of health care in the United States has changed dramatically

More information

Star Quality Ratings: Legal, Operational and Strategic Questions for MA Organizations and Part D Plan Sponsors

Star Quality Ratings: Legal, Operational and Strategic Questions for MA Organizations and Part D Plan Sponsors Where Do We Go From Here? Star Quality Ratings: Legal, Operational and Strategic Questions for MA Organizations and Part D Plan Sponsors American Health Lawyers Association 2011 Payors, Plans and Managed

More information

Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Coventry Health and Life Insurance Company Commercial Lines of Business

Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Coventry Health and Life Insurance Company Commercial Lines of Business Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Coventry Health and Life Insurance Company Commercial Lines of Business Quality Management Program 2012 Overview Quality Improvement

More information

The Star Treatment: Estimating the Impact of Star Ratings on Medicare. Advantage Enrollments. Appendices

The Star Treatment: Estimating the Impact of Star Ratings on Medicare. Advantage Enrollments. Appendices The Star Treatment: Estimating the Impact of Star Ratings on Medicare Advantage Enrollments. Appendices Michael Darden Department of Economics Tulane University Ian M. McCarthy Department of Economics

More information

for Medicaid Members Enrolled as of December 31, 2013

for Medicaid Members Enrolled as of December 31, 2013 Report of Results of 2014 HEDIS /CAHPS Health Plan Survey Adult Medicaid Version for Medicaid Members Enrolled as of December 31, 2013 About This Report........3 HEDIS/CAHPS 5.0H Health Plan Survey......4

More information

NCQA Health Insurance Plan Ratings Methodology April 2014

NCQA Health Insurance Plan Ratings Methodology April 2014 NCQA Health Insurance Plan Ratings Methodology April 204 REVISION CHART Date Published December 203 April 204 Description Draft version Final version TABLE OF CONTENTS Overview..... Ratings vs. rankings...

More information

CAHPS Survey for the Medicare Shared Savings Program and Pioneer Model ACOs. Report for: ACCOUNTABLE CARE ORGANIZATION

CAHPS Survey for the Medicare Shared Savings Program and Pioneer Model ACOs. Report for: ACCOUNTABLE CARE ORGANIZATION CAHPS Survey for the Medicare Shared Savings Program and Pioneer Model ACOs Report for: ACCOUNTABLE CARE ORGANIZATION Issued September 2013 Table of Contents Part 1: Executive Summary... iii Part 2: Detailed

More information

Emergency Room Services Satisfaction Survey

Emergency Room Services Satisfaction Survey Emergency Room Services Satisfaction Survey Date: «NameF» «NameL» «AddressLine1» «AddressLine2» «City», «StateCode» «Zip» Dear Member: TML MultiState Intergovernmental Employee Benefits Pool (IEBP) appreciates

More information

Changes From the 2014 Memo

Changes From the 2014 Memo TO: Interested Organizations FROM: Patrick Dahill, Assistant Vice President, Policy DATE: February 5, 2015 RE: 2015 Accreditation Benchmarks and Thresholds This document reports national benchmarks and

More information

CMS MA Star Ratings Work Group Discussion Forum

CMS MA Star Ratings Work Group Discussion Forum CMS MA Star Ratings Work Group Discussion Forum 2016 First Plan Preview Period August 11, 2015 2016 CMS Star Ratings Updates 2 Methodology Changes to the Overall Star Rating For a few years CMS has expressed

More information

2014 CAHPS Health Plan Survey Database

2014 CAHPS Health Plan Survey Database THE CAHPS DATABASE 214 CAHPS Health Plan Survey Database 214 Chartbook: What Consumers Say About Their Experiences with Their Health Plans and Medical Care AHRQ Contract No.: HHSA292133C Managed and prepared

More information

Improving Quality of Care for Medicare Patients: Accountable Care Organizations

Improving Quality of Care for Medicare Patients: Accountable Care Organizations DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services Improving Quality of Care for Medicare Patients: FACT SHEET Overview http://www.cms.gov/sharedsavingsprogram On October

More information

NCQA Health Plan Accreditation. Rigorous. Flexible. Superior.

NCQA Health Plan Accreditation. Rigorous. Flexible. Superior. NCQA Health Plan Accreditation Rigorous. Flexible. Superior. Health Plan Accreditation Rigorous. Flexible. Superior. Health plans operate in a competitive marketplace, often vying for business with local,

More information

CMS Five-Star Quality Rating System

CMS Five-Star Quality Rating System CMS Five-Star Quality Rating System Pantea Ghasemi, USC Pharm.D. Candidate of 2015 Preceptor Dr. Craig Stern Pro Pharma Pharmaceutical Consultants, Inc. April 24, 2015 Objectives 1. Understand the background

More information

Fact Sheet - 2016 Star Ratings

Fact Sheet - 2016 Star Ratings Fact Sheet - 2016 Star Ratings One of the Centers for Medicare & Medicaid Services (CMS) most important strategic goals is to improve the quality of care and general health status for Medicare beneficiaries.

More information

ANNUAL NOTICE OF CHANGES FOR 2016

ANNUAL NOTICE OF CHANGES FOR 2016 Cigna-HealthSpring Preferred (HMO) offered by Cigna-HealthSpring ANNUAL NOTICE OF CHANGES FOR 2016 You are currently enrolled as a member of Cigna-HealthSpring Preferred (HMO). Next year, there will be

More information

Medicare Part C & D Star Ratings: Update for 2016. August 5, 2015 Part C & D User Group Call

Medicare Part C & D Star Ratings: Update for 2016. August 5, 2015 Part C & D User Group Call Medicare Part C & D Star Ratings: Update for 2016 August 5, 2015 Part C & D User Group Call Session Overview 2016 Star Ratings Changes announced in Call Letter. HPMS Plan Previews. 2016 Display Measures.

More information

Medicare Plan Finder - General Tips

Medicare Plan Finder - General Tips Medicare Plan Finder - General Tips 1. For security purposes, your Medicare Plan Finder session will time out after 30 minutes of inactivity. However, you have the option to extend your session if you

More information

Tips To Improve 5-Star Performance Ratings

Tips To Improve 5-Star Performance Ratings Tips To Improve 5-Star Performance Ratings Two different patient surveys impact CMS Star ratings: 1. The Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, typically mailed to plan

More information

Colorado Small Business Enrollment Guide A BETTER WAY to take care of business

Colorado Small Business Enrollment Guide A BETTER WAY to take care of business 2015 SMALL BUSINESS HEALTH Colorado Small Business Enrollment Guide A BETTER WAY to take care of business Choose BETTER. 31 Important deadline Open enrollment begins on November 15, 2014 for coverage beginning

More information

Immunization Quality Metrics

Immunization Quality Metrics Immunization Quality Metrics Samuel Stolpe, PharmD Senior Director, Quality Strategies sstolpe@pqaalliance.org Discussion Objectives 1. Describe the expanding influence of quality metrics, and their connection

More information

Key Points about Star Ratings from the CMS 2015 Draft Call Letter

Key Points about Star Ratings from the CMS 2015 Draft Call Letter News From February 24, 2014 Key Points about Star Ratings from the CMS 2015 Draft Call Letter On February 21, 2014 CMS released the 2015 Draft Advance Notice and Call Letter for Medicare Advantage plans.

More information

THAT S RIGHT FOR YOU PLATINUM BLUESM WITH RX (COST) Medical and prescription drug benefits you want. Value you deserve. FIND THE PLAN CORE CHOICE

THAT S RIGHT FOR YOU PLATINUM BLUESM WITH RX (COST) Medical and prescription drug benefits you want. Value you deserve. FIND THE PLAN CORE CHOICE 2016 PLATINUM BLUESM WITH RX (COST) Medical and prescription drug benefits you want. Value you deserve. OPTIONS YOU WANT Platinum Blue can help pay the deductibles, copayments and coinsurance Original

More information

Patient Experience Measures from the CAHPS Clinician & Group Surveys

Patient Experience Measures from the CAHPS Clinician & Group Surveys Patient Experience Measures from the CAHPS Clinician & Group Surveys Introduction... 1 Types of Reports... 1 Types of Measures... 2 Measures Based on Core Items in the CAHPS Clinician & Group Surveys...

More information

STAR RATINGS FOR MEDICARE ADVANTAGE PLANS

STAR RATINGS FOR MEDICARE ADVANTAGE PLANS 11 STAR RATINGS FOR MEDICARE ADVANTAGE PLANS A Medicare Advantage (MA) Plan is offered by private health insurance companies that are approved by Medicare which is a social insurance program administered

More information

MEDICARE PRESCRIPTION DRUG PLANS: INFORMATION FOR CONSUMERS

MEDICARE PRESCRIPTION DRUG PLANS: INFORMATION FOR CONSUMERS MEDICARE PRESCRIPTION DRUG PLANS: INFORMATION FOR CONSUMERS Contents: 1. General Information 2. Dates to Remember 3. Frequently Asked Questions Prepared by Susan V. Murray, MSW, CMSW Medical Social Worker

More information

Sick in America Poll

Sick in America Poll Sick in America Poll National Public Radio Robert Wood Johnson Foundation Harvard School of Public Health Released May 2012 Sick in America: Experiences with Health Care Costs Sick being defined as those

More information

CAHPS Survey for ACOs Participating in Medicare Initiatives 2014 Medicare Provider Satisfaction Survey

CAHPS Survey for ACOs Participating in Medicare Initiatives 2014 Medicare Provider Satisfaction Survey CAHPS Survey for ACOs Participating in Medicare Initiatives 2014 Medicare Provider Satisfaction Survey Survey Instructions This survey asks about you and the health care you received in the last six months.

More information

Methodology Overview February 2014

Methodology Overview February 2014 February 2014 REVISION CHART Date Published February Description Initial Version ii TABLE OF CONTENTS Revision Chart... ii Table of Contents... iii 1 Summary... 1 Rankings contact information... 1 2 How

More information

Improving Quality of Care for Medicare Patients: Accountable Care Organizations

Improving Quality of Care for Medicare Patients: Accountable Care Organizations DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services Improving Quality of Medicare Patients: Overview The Centers for Medicare & Medicaid Services (), an agency within the Department

More information

Quality Measures Overview

Quality Measures Overview Quality Measures Overview Health care quality, Stars and Member Engagement Initiatives Approved for External Use Section 1 Introduction Introduction Stars Quality Measures Overview UnitedHealthcare is

More information

Medicare 2015 Part C & D Star Rating Technical Notes DRAFT

Medicare 2015 Part C & D Star Rating Technical Notes DRAFT Medicare 2015 Part C & D Star Rating Technical Notes Updated 09/03/2014 Document Change Log Previous Version Description of Change Revision Date - Initial release of the preliminary 2015 Part C & D Star

More information

2014 Prescription Drug Schedule Humana Medicare Employer Plan

2014 Prescription Drug Schedule Humana Medicare Employer Plan 2014 Prescription Drug Schedule Humana Medicare Employer Plan Option 98 City of Newport News Y0040_GHHHEF3HH14 SECTION I - INTRODUCTION TO SUMMARY OF BENEFITS Thank you for your interest in the Humana

More information

uality Program Work Plan

uality Program Work Plan uality Program Work Plan 2016 Approved by the Quality Improvement Committee: 3/16/16 Approved by the Quality Improvement Advisory and Credentialing Committee: 3/16/16 Approved by the Board of Directors:

More information

CITIZENS CHOICE HEALTH PLAN HMO

CITIZENS CHOICE HEALTH PLAN HMO P L A N H E A L T H C H O I C E C I T I Z E N S 2015 THANKS FOR MAKING THE RIGHT CHOICE WITH CITIZENS CHOICE HEALTH PLAN HMO Navigating Your Way Through the CMS Star Ratings IR_15019EN NAVIGATING YOUR

More information

Medicare Advantage - Stride Quality Program 2015. NH Medical Director Meeting March 2015

Medicare Advantage - Stride Quality Program 2015. NH Medical Director Meeting March 2015 Medicare Advantage - Stride Quality Program 2015 NH Medical Director Meeting March 2015 Medicare Membership New Hampshire has 1000 Medicare Advantage Stride members Counties currently in contracts include

More information

How we measure up 0813 25346WVAMENUNC 01/14

How we measure up 0813 25346WVAMENUNC 01/14 Quality Improvement Program How we measure up At UniCare Health Plan of West Virginia Inc., we focus on helping our members get healthy and stay healthy. To help us serve you the best we can, each year

More information

December 2014. Federal Employees Health Benefits (FEHB) Program Report on Health Information Technology (HIT) and Transparency

December 2014. Federal Employees Health Benefits (FEHB) Program Report on Health Information Technology (HIT) and Transparency December 2014 Federal Employees Health Benefits (FEHB) Program Report on Health Information Technology (HIT) and Transparency I. Background Federal Employees Health Benefits (FEHB) Program Report on Health

More information

2015 PROVIDER TOOLKIT Understanding the Centers for Medicare and Medicaid (CMS) Stars Rating System

2015 PROVIDER TOOLKIT Understanding the Centers for Medicare and Medicaid (CMS) Stars Rating System Understanding the Centers for Medicare and Medicaid (CMS) Stars Rating System 7990 IH 10 West, Suite 300 San Antonio, TX 78230 What is CMS Quality Star Ratings program? CMS evaluates health insurance plans

More information

Guide to Choosing a Medicare Prescription Drug Plan in Connecticut

Guide to Choosing a Medicare Prescription Drug Plan in Connecticut Medicare Prescription Drug - Choosing the Plan that s Right for You! Guide to Choosing a Medicare Prescription Drug Plan in Connecticut Medicare Prescription Drug, also called Part D or Medicare Rx, is

More information

Chapter 5: Getting your outpatient prescription drugs through the plan

Chapter 5: Getting your outpatient prescription drugs through the plan Chapter 5: Getting your outpatient prescription drugs through the plan Table of Contents Introduction... 76 Rules for the plan s outpatient drug coverage... 76 A. Getting your prescriptions filled... 77

More information

Methodology Overview July 2013

Methodology Overview July 2013 July 2013 ii REVISION CHART Date Published May July Description Final version Final with updated measure list iii TABLE OF CONTENTS Revision Chart... iii Table of Contents... iv 1 Summary... 5 Rankings

More information

Health and Care Experience Survey 2013/14 Results for Arran Medical Group- Arran

Health and Care Experience Survey 2013/14 Results for Arran Medical Group- Arran Results for Arran Medical Group The Medical Centre Lamlash Isle of Arran KA27 8NS This report gives a summary of the results of the for. The survey was sent to 329 people registered with the practice.

More information

Application for Free AstraZeneca Medicines:

Application for Free AstraZeneca Medicines: Application for Free AstraZeneca Medicines: PO Box 898, Somerville, NJ 08876 How to Complete this Application: 1. Review the information on this page carefully and keep it for your records. 2. Complete

More information

Meaningful Use. HIEs Should: Medicare EHR incentives. Medicare EHR incentives. Medicaid EHR incentives. Understanding Meaningful Use

Meaningful Use. HIEs Should: Medicare EHR incentives. Medicare EHR incentives. Medicaid EHR incentives. Understanding Meaningful Use Understanding Meaningful Use Core Objectives Meaningful Use Standard functions of EHR specified by CMS 15 core items: - EPs must do all 15 10 menu items - EPs must do 5 - EP gets to choose - Point is to

More information

CDPHP CAHPS 4.0 Adult Medicaid Health Plan Survey

CDPHP CAHPS 4.0 Adult Medicaid Health Plan Survey CAHPS 4.0 Adult Medicaid Health Plan Survey Continuous Quality Improvement Report February 2012 3975 Research Park Drive Ann Arbor, MI 48108 Table of Contents Background 1 Executive Summary 2 CAHPS 4.0

More information

Annual Notice of Changes for 2017

Annual Notice of Changes for 2017 ATRIO Bronze Rx (Umpqua) (PPO) offered by ATRIO Health Plans Annual Notice of Changes for 2017 You are currently enrolled as a member of ATRIO Bronze Rx (Umpqua) (PPO). Next year, there will be some changes

More information

7/31/2014. Medicare Advantage: Time to Re-examine Your Engagement Strategy. Avalere Health. Eric Hammelman, CFA. Overview

7/31/2014. Medicare Advantage: Time to Re-examine Your Engagement Strategy. Avalere Health. Eric Hammelman, CFA. Overview Medicare Advantage: Time to Re-examine Your Engagement Strategy July 2014 avalerehealth.net Avalere Health Avalere Health delivers research, analysis, insight & strategy to leaders in healthcare policy

More information

MA & PDP CAHPS Survey Vendor Training. November 2011

MA & PDP CAHPS Survey Vendor Training. November 2011 MA & PDP CAHPS Survey Vendor Training November 2011 Welcome! In today s MA & PDP CAHPS training, we will: Review Key Concepts and Protocols Provide Updates on the 2012 Survey Administration Review the

More information

Stay Healthy. In the Know. Screenings you and your family need. Protect yourself against health care fraud. www.aultcare.com

Stay Healthy. In the Know. Screenings you and your family need. Protect yourself against health care fraud. www.aultcare.com good health FALL 2015 YOUR FAST TRACK TO LIVING WELL Stay Healthy Screenings you and your family need In the Know Protect yourself against health care fraud www.aultcare.com TELL US HOW WE ARE DOING Whether

More information

Meaningful Use Guidelines: Radiologists

Meaningful Use Guidelines: Radiologists Meaningful Use Meaningful Use (MU) criteria allows providers to demonstrate that they are using certified EHR technology in ways that can be measured significantly in quality and in quantity. Many assume

More information

Medicare Prescription Drug Coverage: How to Request a Coverage Determination, File an Appeal, or File a Complaint

Medicare Prescription Drug Coverage: How to Request a Coverage Determination, File an Appeal, or File a Complaint CENTERS FOR MEDICARE & MEDICAID SERVICES Medicare Prescription Drug Coverage: How to Request a Coverage Determination, File an Appeal, or File a Complaint There are two ways to get Medicare prescription

More information

TO: FROM: DATE: RE: Mid-Year Updates Note: NCQA Benchmarks & Thresholds 2014

TO: FROM: DATE: RE: Mid-Year Updates Note: NCQA Benchmarks & Thresholds 2014 TO: Interested Organizations FROM: Patrick Dahill, Assistant Vice President, Policy DATE: July 25, 2014 RE: 2014 Accreditation Benchmarks and Thresholds Mid-Year Update This document reports national benchmarks

More information

Completing the Pneumococcal/ Influenza Vaccine Assessment Form

Completing the Pneumococcal/ Influenza Vaccine Assessment Form 07302010 1 Completing the Pneumococcal/ Influenza Vaccine Assessment Form An order for the Pneumococcal/ Influenza Vaccine Assessment automatically generates on admission to a non-icu bed for patients

More information

Mode and Patient-mix Adjustment of the CAHPS Hospital Survey (HCAHPS)

Mode and Patient-mix Adjustment of the CAHPS Hospital Survey (HCAHPS) Mode and Patient-mix Adjustment of the CAHPS Hospital Survey (HCAHPS) April 30, 2008 Abstract A randomized Mode Experiment of 27,229 discharges from 45 hospitals was used to develop adjustments for the

More information

2013 California Medicare Prescription Drug Plans (PDPs)

2013 California Medicare Prescription Drug Plans (PDPs) 2013 California Medicare Prescription Plans (PDPs) The following Medicare prescription drug plans are available to California residents. This information was taken from the Medicare Web site, www.medicare.gov.

More information

Annual Notice of Changes for 2014

Annual Notice of Changes for 2014 True Blue Rx Option Il (HMO) offered by Blue Cross of Idaho Health Service, Inc. (Blue Cross of Idaho) Annual Notice of Changes for 2014 You are currently enrolled as a member of True Blue Rx Option Il

More information

How Medicare Works. Helping you make the most of Medicare. MedicareBlue SM Rx (PDP) S5743_101415_B02_RE Internal Approval 11/12/2015

How Medicare Works. Helping you make the most of Medicare. MedicareBlue SM Rx (PDP) S5743_101415_B02_RE Internal Approval 11/12/2015 How Medicare Works Helping you make the most of Medicare 2016 MedicareBlue SM Rx (PDP) S5743_101415_B02_RE Internal Approval 11/12/2015 About Medicare Whether you re new to Medicare or want a refresher,

More information

CAHPS PQRS SURVEY 0938-1222

CAHPS PQRS SURVEY 0938-1222 CAHPS PQRS SURVEY According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control

More information

A contract that requires your health insurer to pay some or all of your health care costs in exchange for a premium.

A contract that requires your health insurer to pay some or all of your health care costs in exchange for a premium. HEALTH INSURANCE A contract that requires your health insurer to pay some or all of your health care costs in exchange for a premium. HI, I m Kate! I Got Health Insurance! Card Member ID: 0000000000 Group

More information

Survey of Healthy San Francisco Participants

Survey of Healthy San Francisco Participants K AISER FAMILY FOUNDATION Survey of Healthy San Francisco Participants AUGUST 2009 TABLE OF CONTENTS Executive Summary.1 Introduction... 3 Key Findings. 5 Discussion and Conclusions 25 Appendix 1: Survey

More information

HCAHPS Star Ratings: Overview and Methodology

HCAHPS Star Ratings: Overview and Methodology HCAHPS Star Ratings: Overview and Methodology October 8, 2014 Presenters: Kate Goodrich, CMS Kristie Baus, CMS Liz Goldstein, CMS William G. Lehrman, CMS The Medicare Learning Network This MLN Connects

More information

Strategies for Success in the CMS Medicare Advantage Star Quality Ratings

Strategies for Success in the CMS Medicare Advantage Star Quality Ratings Strategies for Success in the CMS Medicare Advantage Star Quality Ratings The National Pay for Performance Summit February 20, 2013, San Francisco, CA Theresa C. Carnegie Mintz, Levin, Cohn, Ferris, Glovsky

More information

MEDICARE PART C MEDICARE ADVANTAGE PLANS

MEDICARE PART C MEDICARE ADVANTAGE PLANS City of Boston MEDICARE PART C MEDICARE ADVANTAGE PLANS March 8, 2016 Copyright 2016 by The Segal Group, Inc. All rights reserved. Educational Sessions Schedule Medicare RFP and Prescription Drug Review

More information

Member Satisfaction Survey

Member Satisfaction Survey Member Satisfaction Survey In an effort to identify and understand key influencers of satisfaction and prioritize opportunities for improvement, Evercare Select completed a member satisfaction survey between

More information