Healthplan Report Card

These measures provide an overall understanding of how satisfied members are with their health plan including how well the health plan met their expectations. Information on member satisfaction is obtained from the Consumer Assessment of Healthcare Providers and Systems Survey (CAHPS). Member satisfaction comparison resulted in star ratings of one to five stars on these CAHPS measures, where one is the lowest possible rating and five is the highest possible rating. This data is used by health plans and AHCCCS to identify opportunities for improvement and track progress towards goals. It can also be used by members when deciding which health plan to choose.

The average online wait time in seconds that the member / provider provider waits from the moment the call is connected in the Contractor's phone switch until the call is picked up by a Contractor's representative or Interactive Voice Recognition System (IVR)

These are measures that are used to report the performance of health plans. Data for these measures come from the Healthcare Effectiveness Data & Information Set (HEDIS). For AHCCCS, the HEDIS measures have been a reasonable indicator of health care accessibility, availability and quality. The performance measures provide a standardized way to evaluate Contractor performance in quality management over time allowing members to make an informed decision when choosing a health plan.

The average time it took for Customer Service to answer a call in Seconds (Standard: 45 seconds or less)

The sum of the Daily First Contact Call Resolution Rate divided by the number of days in the reporting period (Standard: 70% or more)

The percentage of children 12 months to 19 years of age that had at least one visit with a PCP during the measurement year (Minimum Performance Standard for age break-downs not aggregate)

The percentage of children that had at least one dental visit during the measurement
year (Minimum Performance Standard 57%)

The percentage of pregnant members that received prenatal care during the first trimester or within 42 days of enrolling with a health plan.