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ACHP Members among ‘America’s Best Health Plans’ - ACHP
- 1. Login ContactUs Blog Archives 2017 2016 2015 07/11/2008 ACHPMembersamong‘America’sBestHealth Plans’ Washington,DC–Healthplansthatemphasizecoordinatedcarebydevelopingstrong partnershipswithphysiciansandhospitalsrankamongthenation’sbestplans.Morethan halfofthetop‐rankedMedicareplansinthenationareofferedbymembersoftheAllianceof CommunityHealthPlans(ACHP).U.S.NewsandWorldReportandtheNationalCommittee forQualityAssurance’s(NCQA)annual“America’sBestHealthPlans”rank6ACHPmembers inthetop10,and13inthetop25,inprovidingthehighestqualityMedicareAdvantage plans. Theannuallist,releasedonlinetoday,alsorankedACHPmembersFallonCommunityHealthFallon PlanofWorcester,MAandUPMCHealthPlanofPittsburgh,PAamongthenation’sbestinall threecategories:Commercial,MedicareandMedicaidplans.Inall,14ofACHP’s17member organizationswererepresentedeitherinthetop25MedicareandMedicaidplansorthetop 50commercialhealthplans. ACHPmembersarecommunity‐basedandregionalhealthplansandproviderorganizations locatedacrossthecountrythatprovidecoverageandhealthservicesforabout15million individuals.Theyshareacommitmenttocoordinatinghealthcaredeliveryandconsistently achievehighqualityratings. ACHPPresidentandCEOPatriciaSmithcommented,“ACHPmembersareimportantmodels asCongressandPresident‐electObamamoveforwardonhealthcarereform.Theseplans arerankedsohighlybecausetheyhavedevelopedinnovativesystemsofcareincorporating electronicmedicalrecords,medicalhomes,chronicdiseasemanagementandclose collaborationbetweenplansandphysicians–allareaswhichareexpectedtobepartof healthcarereform.” Theseplansofferimportantlessonsforhowbesttoᯋ�inanceanddelivercareforconditions thatrequirecoordinatedeffortsacrosssettingsandclosemonitoringofpatientcare.For example,HEDIS scoresusedintherankingsindicatethathealthplansthatarestructured toemphasizeprimarycareandcoordinatedeffortsofthehealthcareteamperformedwell onprovidingmentalhealthfollow‐upvisitsandpersistenceofBetaBlockertreatmentafter heartattacks.“Ifyouconsiderthatgoodresultsonthesetwoservicesrequirecoordination acrossdifferentsettingsandprovidersanddirect,personalinteractionwithpatients,it’snot toogreataleaptosuggestthattheseareoutcomesthathealthplanswithstrongtiesto providersandtheircommunitiesarebestcapableofproducing,”Ms.Smithsaid. “Medicareandotherpublicprograms,aswellasprivatepurchasers,increasinglyare concernedaboutthevalueofthecaretheypayfor,”commentedMs.Smith.“Asweface multiple,competingdemandsforresources,policymakers,employers,andindividual purchaserswoulddowelltolooktohealthplanssuchasthoseofferedbyACHPmembers thataredeliveringgoodhealthoutcomesandpatientsatisfaction.” TheU.S.NewsrankingsarebasedondatafromtheHealthPlanEmployerDataand InformationSet(HEDIS ),theConsumerAssessmentofHealthcareProvidersandSystems ® ® ACHPNews ACHPandourmembersimprovethehealthofthecommunitiesweserve andactivelyleadthetransformationofhealthcaretopromotehigh‐quality, affordablecareandsuperiorcustomerservice.
- 2. InformationSet(HEDIS ),theConsumerAssessmentofHealthcareProvidersandSystems (CAHPS ),andMedicare’sHealthOutcomesSurvey.HEDIS measuresareadministeredby NCQAandareusedtodeterminethequalityofcarepatientsreceiveandhealthplanspayfor. Theytrackawiderangeofservices,includingasthmamedicationuse,diabetescare,and breastcancerscreening.HealthplansuseHEDIS measurestoidentifyareasfor improvementindeliveringcare. CAHPS measuresareadministeredbytheU.S.AgencyforHealthcareResearchandQuality andareusedtodeterminethelevelofpatientsatisfactionwiththecareandexperiencewith providersandhealthcarefacilities.CAHPS measuresallowpatientstoidentifyaspectsof caretheybelievearestrongorinneedofimprovement. About700healthplansvoluntarilyreportedtheircommercial,MedicareandMedicaiddata thisyeartoNCQA.Theseplansprovidecoverageformorethan100millionAmericans–a29 percentincreasefromlastyear.NCQAattributesmuchofthisincreasetotheinclusionof 240PPOplanspubliclyreportingdatafortheᯋ�irsttime.WhiletheinclusionofPPOplansis important,itisnotsufᯋ�icient.Two‐thirdsofAmericans–includingmillionsofseniors coveredbythetraditionalMedicarefee‐for‐servicesystem–receivecarethatisnot measuredandreported.Congresstookanimportantsteptocorrectthisbycallingfora reportfromtheMedicareAdvisoryPaymentCommission(MedPAC),duein2010,onquality measurestocompareMedicareAdvantageplanstofee‐for‐serviceMedicare. ACHPMemberPlansamongHighestRanked Commercial,MedicareandMedicaidPlansin2008 Commercial–Top50 RankPlan 2TuftsHealthPlan 5GeisingerHealthPlan 8GroupHealthCooperativeofSouthCentralWisconsin 13ConnectiCare(ownedbyHIPofNewYork) 15PriorityHealth 17IndependentHealthPlan 18FallonCommunityHealthPlanFallon 19SecurityHealthPlan 23CapitalHealthPlan 26ConnectiCareofMassachusetts(ownedbyHIPofNewYork) 27KaiserFoundationHealthPlanofGeorgia 33HealthPartners ® ® ® ® ® ®