2017 Quality Improvement Program Evaluation

Alliant Health Plans is dedicated to providing high quality healthcare and personalized service to our members by continually seeking to improve health care quality, safety, availability and transparency.  In addition, we strive to improve our business practices in ways that increase member satisfaction with their healthcare and provide a clear understanding of their insurance benefits.

National Recognition by NCQA

Alliant’s Commercial and Marketplace plans are accredited by the National Committee for Quality Assurance (NCQA).

Quality Performance:  HEDIS®

NCQA requires organizations to submit specified Healthcare Effectiveness Data and Information (HEDIS) measures survey results annually.  HEDIS is one of the most widely used sets of heath care performance measures in the United States.  Alliant’s performance on the required HEDIS measures is evaluated against applicable benchmarks and thresholds by product line.  Alliant’s performance goal was set to the 50th percentile for all measures.  This goal was met for most Commercial and Marketplace rates.

Overall, Alliant’s Commercial plan saw rates rise in 15 of its 26 reportable measures.  Some of the greatest strides were in Immunizations for Children and Adolescents, Asthma Medication Management, and Prenatal/Postpartum Care.  The Marketplace plan witnessed a rise in 7 of its 24 reportable measures.  Strengths were found in Comprehensive Diabetes Care and Appropriate Testing for Children with Pharyngitis. Both plans scored high in Follow-up Care for Children with Attention Deficit/Hyperactivity Disorder and Anti-Depressant Medication Management.

 

Quality Performance:  CAHPS and the Quality Health Plan Enrollee Experience Survey

Alliant Health Plans annually assesses member experience to monitor and improve health plan services and member health. The overall objective of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) study is to capture accurate and complete information about consumer-reported experiences with health care. Specifically, the survey aims to measure how well plans are meeting their members’ expectations and goals, determine which areas of service have the greatest effect on members’ overall satisfaction, and identify opportunities for improvement.

Alliant contracts with SPH Analytics to conduct its CAHPS 5.0H Commercial Adult Member Satisfaction Survey and its Qualified Health Plan Enrollee Experience Survey.  NCQA requires health plans to submit CAHPS survey results in compliance with HEDIS accreditation requirements. A random sampling of 1100 members was extracted from eligible members for the Commercial Enrollee Experience Survey.  Auditors from ATTEST Healthcare Advisors reviewed the file for accuracy and integrity and ensured that no bias was present with the selections.

The Commercial survey consisted of 65 questions, of which the following topics were addressed:

  • Getting Needed Care
  • Getting Care Quickly
  • How Well Doctors Communicate
  • Customer Service
  • Claims Processing
  • Shared Decision Making
  • Plan Information and Costs
  • Health Promotion and Education
  • Providing Needed Information
  • Rating of Health Care
  • Rating of Personal Doctor
  • Rating of Specialist
  • Rating of Health Plan
  • Effectiveness of Care

For 2017, Alliant chose a mixed mail survey administration methodology.  This methodology included four waves of mailings (two questionnaire mailings and two reminder postcards) with a telephone follow-up of at least three attempts, in addition to an internet survey component. Alliant’s survey response rate was 22%.  SPH Analytics collected 237 valid surveys from the eligible member population. The overall NCQA target number of valid surveys is 411. Rates are presented in percentages and the NCQA Quality Compass report is used as the benchmark. This report includes all commercial PPO adult samples that submitted data to NCQA in 2017.  In large part, Alliant’s CAHPS scores have trended upwards over the last two years. Member satisfaction with their overall care from the health plan is growing, with most questions reaching the 50th percentile goal satisfaction rate. On the Commercial member satisfaction survey, Alliant came out with strong scores when benchmarked against the other 210 health plans who submitted data for the Quality Compass report.  Out of 40 summary rates, Alliant’s rates were at or above the 50th percentile on 28 questions.  How Well Doctors Communicated is still an area of opportunity, and one that Alliant will be using to educate practitioners on how to better care for their patients.

The QHP survey was also administrated by SHP Analytics.  A random sampling of 1,300 members was extracted from eligible members for the Qualified Health Plan Enrollee Experience Survey.  Rates are presented as scaled mean scores and benchmark comparisons are from SPH Analytics Book of Business.  Auditors from ATTEST Healthcare Advisors reviewed the file for accuracy and integrity, and ensured that no bias was present with the selections. The survey consisted of 90 questions, of which the following topics were addressed:

  • Access to Care
  • Access to Information
  • Care Coordination
  • Cultural Competence
  • Flu Vaccinations for Adults Ages 18-64
  • Plan Administration
  • Rating of All Health Care
  • Rating of Health Plan
  • Rating of Personal Doctor
  • Rating of Specialist
  • Aspirin Use and Discussion
  • Medical Assistance with Smoking and Tobacco Use Cessation

For 2017, CMS requires all plans to use a mixed mail, internet, and phone survey administration methodology.  This methodology included one pre-notification letter, two questionnaire mailings with information about completing the survey online, and one reminder postcard.  Telephone follow-up was allowed, with a maximum of six attempts to reach recipients. SPH Analytics collected 281 valid surveys from the eligible member population, yielding a response rate of 26.6%.

Member satisfaction for the Marketplace Plan met the 50th percentile goal on every survey question, with positive answers increasing from 2016.  For 2018, Alliant will set a new goal of achieving the 75th percentile satisfaction rate and challenge ourselves to continue offering excellent service to our members.  Opportunities for improvement can be seen in the questions revolving around obtaining flu vaccinations, aspirin use and smoking cessation.

For more information about Alliant Health Plans’ quality improvement program, please contact our Customer Service Department, Monday through Friday from 9:00 am – 5:00 pm at:  800-811-4793.

 

 

 

 

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