A Focus on Quality Health Care
N
etwork Health evaluates the quality of care and services provided using two nationally recognized tests, the Healthcare Effectiveness Data and Information Set (HEDIS®) and the Consumer Assessment of Healthcare Providers and Systems (CAHPS®). Each test scores our services in a different way. HEDIS measures preventive care and our care for chronic diseases. CAHPS evaluates customer satisfaction with services provided by customer service, claims and physicians. Both tables show Network Health’s excellent rankings on both state and national levels.
How We’re Doing
(Percentages reflect the number of members who used the offered services and had results within the reported level.) Category Studied Cervical Cancer Screening Childhood Immunization Status Combo 5 (includes DTaP, IPV, MMR, HiB Hepatitis B, ChickenPox, Rotavirus)
86.11%
Ranks 8th
80.4%
Ranks 5th
Wisconsin Health Plans Average Results
National Average Results
78.11%
75.55%
67.56%
87.33%
71.46%
Appropriate Treatment for Children with Upper Respiratory Infection
94.28%
88.63%
83.04%
Prenatal and Postpartum Care – Postpartum Care
93.66%
84.62%
76.19%
Comprehensive Diabetes Care – HbA1c Tested
94.67%
92.27%
88.59%
Comprehensive Diabetes Care – HbA1c Level less than 8%
71.24%
66.36%
58.75%
93.90%
87.79%
85.97%
Cholestrol Management for Patients with Cardiovascular Conditions – LDL-C Tested
Ranks 11th Ranks 29th
Ranks 20th
Ranks 20th
The source for the data reported above is Quality Compass© and is used with the permission of the National Committee for Quality Assurance (NCQA). Any analysis, interpretation, or conclusion based on the data is solely that of the authors, and NCQA specifically disclaims any responsibility for any such analysis, interpretation, or conclusion. Quality Compass is a trademark of NCQA. net workhealth.com
Category/Measure
How often did your health plan’s customer service give you the information or help you needed? How often did the written materials or the Internet provide the information you needed about how your health plan works? How often did your health plan handle your claims correctly?
92.47%
Ranks 22nd
(Percentages reflect the number of members who gave positive reviews.)
57.77%
Adolescent Immunization – Tdap/Td
Ranks 18th
2012 Reporting Year Network Health HMO (Commercial) CAHPS 4.0H Results
How often did your health plan’s customer service staff treat you with courtesy and respect?
2012 Reporting Year Network Health HMO (Commercial) HEDIS Results
Network Health HMO Results – National Ranking
How You Rate Us
Wisconsin Health Plans Average Results
National Average Results
98.60%
94.06%
91.94%
86.11%
81.09%
76.33%
75.97%
66.39%
65.93%
94.79%
90.85%
88.89%
Network Health HMO Results – National Ranking
Ranks 1st
Ranks 19th
Ranks 18th
Ranks 32nd
Quality Program information Each year Network Health’s Quality Improvement (QI) Department updates its QI Program structure to include: > A written description of the QI Program. > Behavioral health care is specifically addressed in the program description. > Patient safety is specifically addressed in the program description. > The QI Program is accountable to the Board of Directors. > A designated physician has substantial involvement in the QI Program. > A designated behavioral health care practitioner is involved in the behavioral health care aspects of the QI Program. > A QI Committee oversees the function of the organization. > The specific role, structure and function of the QI Committee and other committees, including frequency, are addressed in the program description. > An annual quality work plan. > A description of resources the organization devotes to the QI Program. For more information about Network Health’s Quality Improvement Program, please call 920-720-1229, or toll free at 800-826-0940, ext. 01299. 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). W i n t e r 2 01 3
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