About Network Health

How We Rate

Network Health evaluates the quality of care and services provided to members using two nationally-recognized tools, the Healthcare Effectiveness and Data Information Set (HEDIS®) and the Consumer Assessment of Healthcare Providers and Systems (CAHPS®).

Each tool 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. The following tables highlight our 2017 results and show the excellent ratings of Network Health’s Medicare Advantage PPO plans.

Key
5 - Higher Performance 


2
1 - Lower Performance
NA - Not Applicable

Consumer Satisfaction (Score - 4)

Plan Details Score
Getting Care 4.5
Getting Care Easily 5
Getting Care Quickly 4
Satisfaction with Physicians 4.5
Rating of Primary Care Doctor 4
Rating of Specialists 3
Rating of Care 5
Coordination of Care 5
Satisfaction with Health Plan Services 3.5
Rating of Health Plan 3
Customer Service 4

Prevention (Score - 4.5)

Plan Details Score
Breast Cancer Screening 4
Colorectal Cancer Screening 4
Flu Shots     4
Pneumonia Shots 5

Treatment (Score - 4)

Plan Details Score
Diabetes 4
Blood Pressure Control (140/90) 4
Eye Exams 4
Glucose Control 5
Patients with Diabetes - Recieved Statin Therapy 4
Patients with Diabetes - Statin Adherance 3
Heart Disease 3.5
Patients with Cardiovascular Disease - Recieved Statin Therapy 3
Patients with Cardiovascular Disease - Statin Adherance 3
Beta Blocker After Heart Attack 3
Controlling High Blood Pressure 4
Smoking Advice NA
Mental and Behavioral Health 3.5
Depression - Adhering to Medication for 12 Weeks 5
Follow-Up After Hospitalization for Mental Illness 3
Alcohol or Drug Dependence Treatment Initiated 3
Other Treatment Measures
Observed-to-Expected Hospital Readmissions 5
Managing Risk of Falls 2
Avoiding Harmful Drug and Disease Interactions 4
Steriod After Hospitalization for Acute COPD 5
Bronchodilator After Hospitalization for Acute COPD 4
Testing for Osteoporosis 4
Managing Osteoporosis in Women After a Fracture 2
Avoiding High-Risk Medications 5
Non-Recommended Prostate Cancer Screening in Older Men 4

The source for 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.

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).

Quality Program Information

At Network Health, we have our own department that focuses on improving the quality of health care services you receive. Each year, our quality improvement department updates its quality improvement program structure, which includes the following.

  • A written description of the quality improvement program
    • Specifically addressing behavioral health care
    • Specifically addressing patient safety
  • The structure of the quality improvement program, accountable to the Board of Directors
  • A designated physician who has substantial involvement in the quality improvement program
  • A designated behavioral health care professional who is involved in behavioral health care aspects of the program
  • A quality improvement committee that oversees the function of the organization
  • The specific role, structure and function of the quality improvement committee and other connected committees, including how often they meet
  • An annual quality work plan, including progress toward accomplishing goals
  • A description of resources the organization devotes to the quality improvement program

For more information about Network Health's Quality Improvement Program, email us at QI@networkhealth.com.


Network Health
1570 Midway Place
Menasha, WI 54952
Hours
Mon., Wed.-Fri.: 8 a.m. to 5 p.m.
Tuesday: 8 a.m. to 4 p.m.