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Quality & Performance Measures

Quality Management Performance Measures

Quality Management Performance Measures tell Health Choice Arizona how well we are achieving goals set by Medicaid in the areas of preventive health services such as well care visits, dental visits, breast cancer screenings and many more. Medicaid uses Healthcare Effectiveness Data and Information Set (HEDIS®) 2007 specifications to collect and report results of these measures. Developed and maintained by the National Committee for Quality Assurance (NCQA), HEDIS is the most widely used set of performance measures in the managed care industry.

Health Choice Arizona continuously checks our Quality Management Performance Measures to identify areas for improvement and apply interventions to help more of our members use preventive services so they can stay healthy!

2016 AHCCCS Performance Breakout

 

2016 CAHPS Performance

NCQA Comparisons

In order to assess the overall performance of the Acute Care program’s adult Medicaid population, each of the CAHPS global ratings (Rating of Health Plan, Rating of All Health Care, Rating of Personal Doctor, and Rating of Specialist Seen Most Often), four of the CAHPS composite measures (Getting Needed Care, Getting Care Quickly, How Well Doctors Communicate, and Customer Service), and one individual item measure (Coordination of Care) were scored on a three-point scale using the scoring methodology detailed in NCQA’s HEDIS Specifications for Survey Measures.3-1 The resulting three-point mean scores were compared to NCQA’s HEDIS Benchmarks and Thresholds for Accreditation Based on this comparison, ratings of one () to five () stars were determined for each CAHPS measure, where one is the lowest possible rating and five is the highest possible rating.

 

indicates a score at or above the 90th percentile
indicates a score at or between the 75th and 89th percentiles
indicates a score at or between the 50th and 74th percentiles
indicates a score at or between the 25th and 49th percentiles
indicates a score below the 25th percentile

 

2016 Adult CAHPS

 Contractor Name  Rating of Health Plan  Rating of All Health Care  Rating of Personal Doctor  Rating of Specialist Seen Most Often
 Acute Care Program

 

2.46

 

2.44

 

2.53

 

2.54

Health Choice Arizona

2.33

2.31

2.43

2.48

Contractor Name  Getting Needed Care  Getting Care Quickly  How Well Doctors Communicate  Customer Service  Coordination of Care
 Acute Care Program

 

2.36

 

2.41

 

2.59

2.55

2.27

Health Choice Arizona

2.25

2.32

2.52

2.53

2.22

 

2016 Child CAHPS

 Contractor Name  Rating of Health Plan  Rating of All Health Care  Rating of Personal Doctor  Rating of Specialist Seen Most Often
 Acute Care Program

2.64

2.65

2.70

2.57

Health Choice Arizona

2.60

2.63

2.70

2.42*

Contractor Name  Getting Needed Care  Getting Care Quickly  How Well Doctors Communicate  Customer Service  Coordination of Care
 Acute Care Program

 

2.41

 

2.58

 

2.71

2.57

2.33

Health Choice Arizona

2.30

2.58

2.74

2.53*

2.22*

From CAHPS Report – *indicates fewer than 100 respondents. Caution should be exercised when evaluating these results.

 

You can check the AHCCCS website for more information about performance measures: