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:
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||4|
|Getting needed care||4|
|Rating of specialists||4|
|Coordination of care||5|
|Annual flu vaccine||4|
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|| 5|
| Adolescent immunizations|| 5|
| Prenatal care|| 4|
| Postpartum care|| 5|
|Cervical cancer screening|| 5|
| Colorectal cancer screening||5|
| Weight assessment & counseling for children/adolescents: BMI percentile assessment||4|
|Diabetes - blood pressure control||5|
| Diabetes - eye exams||5|
| Diabetes - glucose control||4|
| Patients with diabetes - receive statins||4|
| Patients with diabetes - staying on statins||5|
|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||5|
| Follow-up after hospitalization for mental illness - within 7 days||4|
| Follow-up after emergency department visit for mental illness - within 7 days||4|
| Follow-up after emergency department visit for alcohol and other drug abuse or dependence - within 7 days||4|
| Antidepressant medication management||4|