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Not Accredited
Last update: 11/19/2024
Ratings are updated annually (September)
Partial Data Reported
Insurance Type
Product Type
Next Review Date
Members Enrolled
Evaluation Product
Cms Contract
Special Project
Special Needs
I
I
Did members get appointments, preventive care, tests and treatment easily?
NA
Did members get appointments, preventive care, tests and treatments promptly?
NA
I
Did members rate their primary-care doctors high overall?
NA
Did members rate specialists high overall?
NA
Were members satisfied with how their primary provider coordinated care with other providers?
NA
I
Did members rate their plan services high overall?
NA
Did members rate their care high overall?
NA
I
Did members ages 50 to 74 who are recommended for routine breast cancer screening get a mammogram every 2 years?
NA
Were members ages 45 to 75 screened for colorectal cancer?
NA
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 health plans have information about their members’ race and ethnicity in order to provide appropriate services?
I
I
Were members ages 3 years and older with a sore throat given strep tests and appropriately prescribed antibiotics?
NA
Were members ages 3 months and older with colds not prescribed antibiotics up to 3 days after their diagnosis, as recommended?
NA
Were members ages 3 months and older with acute bronchitis not prescribed antibiotics in the 3 days after their diagnosis, as recommended?
NA
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
I
Did members ages 18 to 75 with diabetes have their blood pressure below 140/90 at their last visit?
NA
Did members ages 18 to 75 with diabetes have a retinal or dilated eye exam?
NA
Did members ages 18 to 75 with diabetes maintain their blood sugar level below 8 percent?
NA
Did members ages 40 to 75 with diabetes who do not have cardiovascular disease receive a statin medication?
NA
Did members ages 40 to 75 with diabetes who do not have cardiovascular disease stay on statin therapy as prescribed?
NA
Did members ages 18 to 85 with diabetes receive a kidney health evaluation?
NA
I
Did males ages 21 to 75 and females ages 40 to 75 with cardiovascular disease receive a high or moderate-intensity statin medication?
NA
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?
NA
Did members ages 18 to 85 with hypertension have their blood pressure controlled (<140/90 mm Hg)?
NA
I
Were members ages 6 and older hospitalized with a mental illness followed up with, within a week after discharge?
NA
Were members ages 6 and older with an ED visit for mental illness followed up with, within a week of their visit?
NA
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?
NA
I
Did members ages 18 and older with schizophrenia or schizoaffective disorder stay on antipsychotic medications as prescribed?
NA
Did members ages 18 and older with a new episode of depression take a prescribed antidepressant medication for at least 6 months?
NA
Did members ages 13 and older with a new episode of substance use disorder engage in treatment within 34 days?
NA
I
Were members 70 years old and older not screened unnecessarily for prostate cancer using prostate-specific antigen based screening?
NA
Were members not prescribed drugs considered potentially harmful because of their disease or condition?
NA
Were members ages 67 and older not prescribed potentially risky medications?
NA
Were members who fell or had problems with balance or walking seen by a practitioner and receive intervention to lower their risk?
NA
Did women ages 67 to 85 with a fracture get a bone mineral density test or appropriate drugs in the next 6 months?
NA
Did women ages 65 to 75 receive osteoporosis screening?
NA
I
Were members with multiple high-risk chronic conditions ages 65 and older followed up within a week of their visit?
NA
For members ages 65 and older who were hospitalized, did their primary care practitioner or ongoing care provider receive notification of admission on the day of admission through 2 days after admission?
NA
For members ages 65 and older who were hospitalized, did their primary care practitioner or ongoing care provider receive discharge information on the day of discharge through 2 days after discharge?
NA
For members ages 65 and older who were hospitalized, what percentage were engaged by their primary care team within 30 days after discharge?
NA
For members ages 65 and older who were hospitalized, what percentage had their medications reconciled within 30 days of discharge?
NA
I
For members ages 65 and older, how many acute inpatient and observation stays were followed by an unplanned acute readmission within 30 days after discharge compared to the expected?
NA
For members ages 65 and older, how many emergency department visits occurred during the year compared to the expected?
NA
For members ages 65 and older, how many acute inpatient and observation stays occurred during the year compared to the expected?
NA
For members ages 67 and older, how many hospitalizations were preventable compared to the expected?
NA
For members ages 65 and older, how many discharges from skilled nursing facilities were followed by an unplanned acute hospitalization within 30 days compared to the expected?
NA
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