We’re working hard every day to provide the highest-quality coverage possible. It’s the kind of peace of mind that comes with being a Prevea360 Health Plan member.
Member Satisfaction/Quality of care. We measure our member satisfaction through a nationally-standardized member satisfaction survey, known as CAHPS. And we monitor our quality of care through a nationally standardized set of measures: Healthcare Effectiveness and Data Information Set (HEDIS).
Patient Safety. Patient Safety is one of the most important aspects of health care. Prevea360 Health Plan is committed to providing you with information that enables you to take an active role in obtaining the safest care possible.
Quality Improvement Program. We are committed to improving the health and health care of our members. We provide educational materials and resources to help members make informed decisions regarding their health.
HIPAA Transactions. Prevea360 Health Plan supports all HIPAA-compliant electronic transactions.
Fraud. Together, we can work to help control the cost of health care.
Prevea360 Health Plan is constantly monitoring our quality performance through national and regional standards as determined by the National Committee for Quality Assurance (NCQA).
NCQA is an independent, not-for-profit organization dedicated to measuring the quality and awarding levels of accreditation based on the results of the Healthcare Effectiveness Data and Information Set (HEDIS® is a registered trademark of the National Committee for Quality Assurance. NCQA HEDIS Compliance Audit® is a registered trademark of NCQA) and the Consumer Assessment of Healthcare Providers and Systems (CAHPS®).
These standards are purposely set high to encourage health plans to continuously improve the quality of care and customer service.
Medicare evaluates plans based on a five-star rating system. Star Ratings are calculated each year and may change from one year to the next.
CMS rated 471 Medicare Advantage contracts in the U.S. For 2022, fewer than 75 of those health plans in the U.S. earned 5 Stars.