Medical Insurance Unit 2
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hs215_unit_2_discussion_question.docxRefer to the below table, The number of health plans with an “excellent” rating, the significance of an “excellent” rating, and the accreditations for the plans.
Do you think that health plan report cards are valuable? Why or why not?
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14 results match your search |
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A health plan may not be listed on this site for any of these reasons: 1. Plans use many different names in the different areas they serve. If your plan is not listed, be sure to review the list of additional names your health plan may use to see if it is included under a different name on our report card. Additional plan names are listed under the plan name on the search results page. 2. Some health plans choose not to participate in NCQA’s programs. Enrolling in an NCQA Accredited plan is one of the best ways to ensure that you and your family will get the care, service and consideration you need, when you need it. Contact your plan to see if they have applied for and received NCQA Accreditation. If a plan chooses not to be reviewed by NCQA, you should ask: Why not? If you receive health care coverage through your employer, talk with them about offering NCQA-accredited plans. Health plans are more likely to focus on quality and seek accreditation if encouraged to do so by health plan members and employers who make decisions about which plans to choose.
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Plan name is the name of the organization that provides health care coverage to individuals and families. The Accreditation Type is the type of NCQA Accreditation the health plan has received. Types include First, Interim, Renewal (Health Plan Accreditation 2013), and Health Plan Accreditation (Before 2013). Indicates whether this Accreditation is scored based on HEDIS results. Indicates whether this Accreditation is scored based on CAHPS results. The Plan Type refers to a specific plan that is designed to provide health care coverage to a certain population or group of people. NCQA divides plan type by Commercial , Medicare , and Medicaid . An Accredited Product is the type of health plan offered by different health care organizations. NCQA divides Accredited Product by HMO , POS and PPO . Overall Accreditation Status refers to the level of NCQA Accreditation a plan has received. NCQA Accreditation is a thorough and rigorous evaluation of a health plan for quality measurement and continuous quality improvement by NCQA. What’s new about accreditation scoring? A change to NCQA’s accreditation scoring methodology that we began making July 1, 2011, will—slowly over five years—make it harder for health plans to reach the highest levels of accreditation (Excellent or Commendable). The change is the elimination of the "sampling variation scoring adjustment." That is NCQA’s practice from 1999 (when we incorporated performance measurement into accreditation) of adding five extra points to HEDIS and CAHPS results. Given that we have added more measures over time and the performance on those measures has become more stable, we announced that we no longer need this scoring adjustment. We also note that health plans have raised their performance over time. By phasing out the scoring adjustment, NCQA is raising the bar in order to drive further improvement. For more information visit www.ncqa.org/Accreditation_Scoring . A health plan may not be listed on this site for any of these reasons: 1. Plans use many different names in the different areas they serve. If your plan is not listed, be sure to review the list of additional names your health plan may use to see if it is included under a different name on our report card. Additional plan names are listed under the plan name on the search results page. 2. Some health plans choose not to participate in NCQA’s programs. Enrolling in an NCQA Accredited plan is one of the best ways to ensure that you and your family will get the care, service and consideration you need, when you need it. Contact your plan to see if they have applied for and received NCQA Accreditation. If a plan chooses not to be reviewed by NCQA, you should ask: Why not? If you receive health care coverage through your employer, talk with them about offering NCQA-accredited plans. Health plans are more likely to focus on quality and seek accreditation if encouraged to do so by health plan members and employers who make decisions about which plans to choose.
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