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Accredited
Last update: 11/19/2024
Ratings are updated annually (September)
4.0 of 5
Insurance Type
Product Type
Next Review Date
Members Enrolled
Evaluation Product
Website
Other Accreditations, Certifications, and Distinctions
Did members get appointments, preventive care, tests and treatment easily?
Did members get appointments, preventive care, tests and treatments promptly?
Did members rate their primary care doctors high overall?
Did members rate specialists high overall?
Were members satisfied with how their primary provider coordinated care with other providers?
Did members rate their plan services high overall?
Did members rate their care high overall?
Did children receive all recommended immunizations by age 2?
Did children receive all 3 recommended immunizations by age 13?
Did members ages 3 to 17 have their BMI assessed?
Did members who gave birth have a prenatal visit in their first trimester or shortly after enrolling in a health insurance plan?
Did members who gave birth have a postpartum visit on or between 7 and 84 days after delivery?
Did members who gave birth receive both recommended immunizations by their delivery date?
Did health plans have information about their members’ race and ethnicity in order to provide appropriate services?
Did members ages 50 to 74 who are recommended for routine breast cancer screening get a mammogram every 2 years?
Were members ages 45 to 75 screened for colorectal cancer?
Did members ages 21 to 64 who are recommended for routine cervical cancer screening receive it?
Did members ages 16 to 24 who are recommended for chlamydia screening get tested?
Did members ages 19 and older receive recommended influenza immunizations?
Did members ages 19 and older receive recommended Td/Tdap immunizations?
Did members ages 50 and older receive recommended zoster immunizations?
Did members 66 and older receive recommended pneumococcal immunizations?
Did members, ages 5 to 64, with persistent asthma have an appropriate ratio of asthma medications to help control their symptoms?
Were members ages 3 years and older with a sore throat given strep tests and appropriately prescribed antibiotics?
Were members ages 3 months and older with colds not prescribed antibiotics up to 3 days after their diagnosis, as recommended?
Were members ages 3 months and older with acute bronchitis not prescribed antibiotics in the 3 days after their diagnosis, as recommended?
Did members ages 40 and older who were hospitalized or had an ED visit for chronic obstructive pulmonary disease receive systemic corticosteroids within 14 days of discharge?
NA
Did members ages 40 and older who were hospitalized or had an ED visit for chronic obstructive pulmonary disease receive a bronchodilator within 30 days of their discharge?
NA
Did members ages 18 to 75 with diabetes have their blood pressure below 140/90 at their last visit?
Did members ages 18 to 75 with diabetes have a retinal or dilated eye exam?
Did members ages 18 to 75 with diabetes maintain their blood sugar level below 8 percent?
Did members ages 40 to 75 with diabetes who do not have cardiovascular disease receive a statin medication?
Did members ages 40 to 75 with diabetes who do not have cardiovascular disease stay on statin therapy as prescribed?
Did members ages 18 to 85 with diabetes receive a kidney health evaluation?
Did males ages 21 to 75 and females ages 40 to 75 with cardiovascular disease receive a high or moderate-intensity statin medication?
Did males ages 21 to 75 and females ages 40 to 75 with cardiovascular disease stay on high or moderate-intensity statin therapy as prescribed?
Did members ages 18 to 85 with hypertension have their blood pressure controlled (<140/90 mm Hg)?
Were members ages 6 and older hospitalized with a mental illness followed up with, within a week after discharge?
Were members ages 6 and older with an ED visit for mental illness followed up with, within a week of their visit?
Were members ages 13 and older with an ED visit for a diagnosed substance use disorder followed up with, within a week of their visit?
Were members ages 13 and older with an inpatient visit, residential treatment visit, or medically managed withdrawal event for a diagnosed substance use disorder followed up with, within a week of their visit or discharge?
Did members ages 18 and older with schizophrenia or schizoaffective disorder stay on antipsychotic medications as prescribed?
Did members ages 18 and older with a new episode of depression take a prescribed antidepressant medication for at least 6 months?
Did members ages 16 and older with a new episode of opioid use disorder treatment stay on recommended medications for at least 6 months?
Did members ages 1 to 17 who were on 2 or more antipsychotic medications have their blood sugar and cholesterol tested?
Did members ages 1 to 17 who had a new prescription for an antipsychotic medication have documentation of psychosocial care as first-line treatment?
NA
Did children ages 6 to 12 who were on ADHD medication for at least 210 days have at least 2 follow-up visits within 9 months?
Did members ages 13 and older with a new episode of substance use disorder engage in treatment within 34 days?
For members ages 18 and older, how many acute inpatient and observation stays occurred during the year compared to the expected?
For members ages 18 to 64, how many acute inpatient and observation stays were followed by an unplanned acute readmission within 30 days after discharge compared to the expected?
For members ages 18 and older, how many emergency department visits occurred during the year compared to the expected?
Were imaging tests appropriately not recommended for members ages 18 to 75 with a new episode of low back pain?
This Plan’s Other Accreditations, Certifications and Distinctions
Accreditation status last updated on 11/19/2024
Health Equity Accreditation
This program offers distinction to organizations that engage in efforts to improve culturally and linguistically appropriate services and reduce health care disparities.
Insurance type
Commercial HMO
Next Review Date
12/09/2025
Status
Accredited
Sharp Health Plan Choice Network, Sharp Health Plan Performance Network, Sharp Health Plan Premier Network, Sharp Health Plan Value Network
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