HEDIS and CAHPS Measures
Network Health Plan participates in two nationally-recognized processes to evaluate the quality of the care and service received by its participants:
Healthcare Effectiveness Data and Information Set (HEDIS)
These measurements evaluate preventive and chronic disease care.
Consumer Assessment of Healthcare Providers and Systems (CAHPS)
This is a survey that measures customer satisfaction with a health plan’s customer service, claims payment process and physicians and providers.
Network Health Plan 2010 HEDIS® Results
The chart below compares the number of Network Health Plan participants who receive preventive care services compared with state and national averages.
| Area Studied | NHP Results | National Average | WI Average |
| Spirometry Testing - COPD |
83.24% | 37.91% | 39.90% |
| Prenatal and Postpartum Care |
95.19% | 72.76% | 82.12% |
| Cholesterol Management for cardiovascular conditions: <100 mg/dL |
72.96% | 53.98% | 64.15% |
| Cervical Cancer Screening Rate |
87.88% | 76.13% | 78.55% |
| Disease Modifying Anti-Rheumatic Drug Therapy In Rheumatoid Arthritis |
94.77% | 86.51% | 93.48% |
| Childhood Immunizations - IPV | 96.52% | 81.70% | 87.02% |
| Childhood Immunizations - Pneumococcal conjugate | 92.34% | 75.78% | 82.73% |
| Childhood Immunizations - Hepatitis B | 97.22% | 84.35% | 76.89% |
| Childhood Immunizations - MMR | 94.66% | 91.00% | 86.96% |
| Childhood Immunizations - Combo 2 (fully immunized) | 87.24% | 65.21% | 73.09% |
| Childhood Immunizations - Combo 3 (fully immunized) | 84.69% | 61.48% | 78.78% |
| Appropriate Treatment for Children with Upper Respiratory Infection | 94.72% | 89.34% | 83.40% |
| Comprehensive Diabetic Care - Blood Pressure <130/<80 | 44.20% | 33.37% | 40.90% |
| Comprehensive Diabetic Care - HbA1c Testing | 95.02% | 86.93% | 90.44% |
| Diabetic Poor HbA1c Control (note: lower percentage is desirable) | 14.75% | 26.96% | 32.91% |
Network Health Plan 2010 CAHPS Results
This chart shows Network Health Plan’s most recent customer satisfaction scores. The numbers say it all!
| Category / Measure | Network Health Plan Result | National Average | Wisconsin Average |
| Claims handled quickly | 93.03% | 86.24% | 87.16% |
| Claims processed accurately | 96.19% | 88.99% | 90.92% |
| Customer service | 86.52% | 75.73% | 80.19% |
| Courtesy and respect | 95.48% | 90.97% | 92.72% |
| Forms Easy to Fill Out | 97.66% | 94.96% | 95.37% |
| Prescription Cost Information Available | 78.68% | 68.79% | 69.79% |
HEDIS and CAHPS Measures
HEDIS and CAHPS results help both employers and consumers compare the quality of care and customer service offered by health plans in the United States. These results are also used by the National Committee for Quality Assurance (NCQA) to evaluate health plans. Our results have allowed us to earn Excellent status from NCQA since 2002!