2019 Quality Summary 1 Performance Measures Summary Performance
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2019 Quality Summary 1
Performance Measures Summary Performance Measures 2019 Healthy U HEDIS SUMMARY Declined 29% Improved 65% No Change 6% CAHPS 2019 Adults Rating of Personal Doctor – Increased 5. 27 percentage points Rating of Specialist – increased 5. 15 percentage points Rating of all Health Care – increased 6. 02 percentage points Rating of Health Plan – increased 1. 18 percentage points
HEDIS Measures Highlights Notable Results or Improvements: • • • W 34 - Well Child Screenings improved 4. 31% points CDC - DM Eye Exams improved 2. 44 % points PPC – Prenatal Care increased by 10. 95 % points (measure changed) PPC – Postpartum Care 21. 42 % points (measure changed) CIS- Childhood Immunizations Combo -3 – 75 th Percentile AAP Adult Access to Preventive/Ambulatory Services- 75 th Percentile Opportunities to Improve to Goal 75 th percentile : • • Breast Cancer Screening rates only improved slightly – 10 th percentile Cervical Cancer Screening rates declined -10 th percentile AMM – improved by 3. 31 % points - 25 th percentile CDC eye exams - 25 th percentile 3
2019 Improvement Activities Member Outreach/Campaigns • • Well Child Visit Gift Card Promotion (postcards, email, letters) • 2019 $25 gift cards - 4, 634 – Continues in 2020 – through July - 2, 392 Reminders for Cervical and Breast Cancer Screenings Reminders to members needing a DM eye exam screening with a form to connect results back to their PCP Prenatal Flyer Virtual Prenatal Care Program Access Assistance 24 Hour Nurse Hot Line 24 Hour Medication/Pharmacy Hot Line Customer Service and Experience: • • • Culture of Excellence - Internal training on customer service Track KPI’s closely on member experience – answer times, resolution rates etc. Numerous website member experience enhancements
Care Management Programs U Baby Maternal Health Empower U Palliative Life Planning Preventive Health & Wellness Community Outreach Behavioral Health Home Visits For more information about our Care Management team or programs please call 833 -981 -0212.
Planned and in-progress • • • New Member Portal • Customized Benefit View • Message Center • Personalized Banners sensitive to care gaps • Improved Provider Search • Educational Resources and links New Care Management Platform Personal Touch – Telephonic outreach program to solve access issues, close care gaps and directly support members needs or questions Develop medication adherence reporting and multi-channel outreach strategy U of U Health System Collaboration – CIN Pilot with Social Work, Clinical Pharmacists, Clinic Case Managers Expand data sharing and explore value based arrangements focused upon quality metrics with our network of clinics and providers
