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Providing you with quality service
Providing you with quality service
Making sure you get the highest quality care when you need it is our goal. We partner with local providers who understand your needs. And the National Committee for Quality Assurance (NCQA) continues to accredit us. This is because we score high on:
- Clinical quality surveys
- Member satisfaction surveys
- NCQA surveys
Healthcare Effectiveness Data and Information Set (HEDIS®) scores
We want to improve access to quality health care for our members. You have a large network of providers to help you be as healthy as you can be. This includes:
- Obstetrician/gynecologists (Ob/Gyns)
- Pediatricians
- Top hospitals
- Community groups
HEDIS scores help us make sure we’re meeting our goals.
What is HEDIS?
HEDIS is one of health care’s most widely used performance improvement tools. HEDIS measurement allows consumers to compare health plan performance to other plans and to national or regional benchmarks. We use these measurements to evaluate the quality of the care and services given to our members and to track year-to-year performance. HEDIS is one component of NCQA's accreditation process required by state regulators.
HEDIS measures
HEDIS includes more than 90 measures across 6 areas of care, including:
- Effectiveness of care
- Access/availability of care
- Experience of care
- Utilization and risk adjusted utilization
- Health plan descriptive information
- Measures reported using electronic clinical data systems
You can find our HEDIS scores (performance measures) and compare with other health plans on the Arizona Health Care Cost Containment System website.
You can also learn more about HEDIS on the NCQA website.
Member satisfaction surveys
We want you to be happy with our services and the care you receive from our providers. We use surveys to ask members (or in some cases, their families) about their experiences with health care services in different settings. We use the results of those surveys to improve the ways we take care of our members.
What is the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey?
The CAHPS survey is what we use to collect data about our members’ experience. This survey asks questions that focus on matters that our members find important. It tells us how they rank our health plan, our operations and our health care providers, including doctors, hospitals, physician practices and other health care providers and facilities.
CAHPS also asks about experiences with other aspects of health care, including:
Getting needed care
Getting care quickly
How well doctors communicate
Health plan customer service
Overall rating of health plan
The CAHPS survey is another component of NCQA's accreditation process required by state regulators. NCQA publishes Health Plan Ratings each year. They rate all the health plans on a scale of 0 to 5 (0 is lowest) in .5 increments. You can find our ranking and other health plans on the NCQA website.
Note: Your answers on our CAHPS surveys are private. You can learn more about CAHPS on the NCQA website. Or you can contact us.
Annual results
Each year, we report our HEDIS and CAHPS survey results to the state agencies and to NCQA. The Arizona agencies and NCQA publish an annual report card. The rankings are shown with stars.
Your voice matters
If you get a member satisfaction survey, be sure to take the time to complete it. We do our best to earn the highest scores (9 or 10) from our members. If you’re not happy with your health care or service, we want to know. Just contact us.
Quality matters
We work hard to make sure you get the best health care and service. Each year, we look at how well we are doing. We set goals for care and service. If we don’t reach our goals, we make a plan to help us improve and reach our goals in the future.
We use HEDIS to measure if our members are getting good care. HEDIS is used across the country to compare health plans.
- Well-child visits
- Adolescent well care
- Childhood weight and nutritional counseling
- Child and adolescent immunizations
- Lead screening in children
- Timely prenatal and postpartum care
- Management of complex conditions, such as high blood pressure, diabetes and asthma
- Breast and cervical cancer screening
- Care of members with diabetes (A1c testing, annual eye exam, etc.)
- Follow-up after hospitalization for mental illness or substance abuse
- Follow-up care for children prescribed ADHD medication
- Treatment for depression
Get feedback from members
Learn more about our members’ needs
Compare our service to other health care plans
Find ways to improve
- Overall health care
- Getting needed care quickly and easily
- Personal doctor
- Specialist seen most often
- How well doctors communicate
- Customer service at Mercy Care
- Mercy Care as a whole
Our goals and objectives
Our goals and objectives
Our goal is to help you take care of your health and get the best care and services. The Quality Improvement (QI) Program helps us to make sure that our services meet high standards for safety and quality. We look at ways to better members’:
- Satisfaction
- Safety
- Services
- Access to doctors
We also always look for ways to make our services better. We do that by:
- Measuring the quality and effectiveness of care and services
- Making sure we use the best ways to check our services
- Having qualified, competent and knowledgeable staff
- Focusing on important problem areas
- Being aware of our members’ culture and language needs
- Making sure that we meet state and federal laws
- Meeting all requirements of health care accreditation
- Making sure we have a good network of doctors and hospitals
- Making sure doctors and staff keep member info private
Every year we review our QI Program to be sure it meets guidelines. We look for ways to improve. This helps us make the QI Program better for next year.
Want to learn more about the QI Program? Just contact us.
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