Our member satisfaction level is determined by members like you. We participate in the nationally standardized member satisfaction survey – known as CAHPS – every year.

The Agency for Healthcare Research and Quality and the National Committee for Quality Assurance (NCQA) have developed a health plan member survey called the Consumer Assessment of Healthcare Providers and Systems (CAHPS). CAHPS is a tool for measuring health plan member satisfaction. 

Across the country, health plans work to achieve a rating of five on a scale of 1 to 5. The survey asks members about:

  • claims processing
  • customer service
  • health care services

It gathers information from members so health plans around the country can compare performance.

For 2021 only, NCQA is responding to the potential impact of COVID-19 on health plan scores by implementing a Special Overall Rating policy. 2021 ratings will display the better of the Overall Rating score between Health Plan Rating 2019 and Health Plan Rating 2021.  

For plans with Accredited, Provisional and Interim status as of June 30, 2021. Individual measures, sub-composites and composites will continue to be scored and displayed during HPR 2021 performance data (i.e., MY 2020 data for all plans). Refer to the NCQA Health Plan Ratings Methodology for details about the Special Overall Rating Policy.

For 2021, Prevea360 Health Plan scored a 4 or a 5 out of 5 on the following Commercial consumer experience survey questions in NCQA’s Health Plan Ratings 2021-2022:

Member Satisfaction Survey
NCQA rating out of 5
Getting care easily
Getting needed care
Rating of specialists
Coordination of care5
Annual flu vaccine4

Quality of care

HEDIS ratings

We use a nationally standardized set of measures called the Healthcare Effectiveness and Data Information Set (HEDIS) to monitor our quality. The measures were created by the National Committee for Quality Assurance (NCQA) so employers, individuals and families have information to compare health plans' performance.

More than 90% of all health insurance companies utilize HEDIS as a trusted source of standardized measures. The NCQA is an independent, not-for-profit organization that evaluates health plans based on more than 50 standards of care and service to determine each health insurance company’s accreditation status.

For 2021 Prevea360 Health Plan was rated a 4 or 5 out of 5 on the following Commercial quality measures in NCQA’s Private Health Insurance Plan Ratings 2021–2022:

Prevention & screening
NCQA rating out of 5
 Childhood immunizations
 Adolescent immunizations
 Prenatal care
 Postpartum care
 Cervical cancer screening  5
 Colorectal cancer screening
 Weight assessment & counseling for children/adolescents: BMI percentile assessment

 Diabetes care
 Diabetes - blood pressure control 5
 Diabetes - eye exams
 Diabetes - glucose control
 Patients with diabetes - receive statins
 Patients with diabetes - staying on statins

 Heart disease
 Patients with cardiovascular disease - staying on statins 5
 Controlling high blood pressure 5

 Treatment & screening
 Appropriate testing & care for children with a sore throat 5
 Appropriate treatment for upper respiratory infection 5
 Use of imaging studies for low back pain 4
 Steroid after hospitalization for acute COPD 5
 Avoiding opioids from multiple prescribers & pharmacies 4

 Behavioral health & AOD services
 Care for children and adolescents on antipsychotics
 Follow-up after hospitalization for mental illness - within 7 days
 Follow-up after emergency department visit for mental illness - within 7 days
 Follow-up after emergency department visit for alcohol and other drug abuse or dependence - within 7 days
 Antidepressant medication management