Quality
Nothing matters more to Arise Health Plan than providing quality care to members. Our guiding principle is to provide services that are safe, timely, effective, efficient, equitable, and member-centered. We’re dedicated to maintaining an active quality improvement program that includes both clinical and service quality initiatives. Click on this pdf to review the Arise Health Plan Quality Improvement Program Summary.
Quality Improvement
The National Committee for Quality Assurance (NCQA) measures quality and performance using two tools: CAHPS® (Consumer Assessment of Healthcare Providers & Systems) and HEDIS® (Healthcare Effectiveness Data & Information Set).
CAHPS® is a member satisfaction survey used to evaluate the experience a patient has with a health care organization. By measuring the patient-centeredness of care, CAHPS® helps organizations assess and improve quality.
We are proud of our recent results and continue to strive toward our goal of exceeding the 90th percentile nationally.
Click on the blue tabs below and view our recent results.
2011 CAHPS® Performance Data
- Health Plan
Health Plan
Percentage of members rated Arise Health Plan as an 8, 9, or 10 on a scale of 0-10 with 0 meaning the worst possible and 10 meaning the best possible
Arise Health Plan: 62.77%National Average: 62.43%- Health Care
Health Care
Percentage of members rated their health care as an 8, 9, or 10 on a scale of 0-10 with 0 meaning the worst possible and 10 meaning the best possible
Arise Health Plan: 77.26%National Average: 76.26%- Personal Doctor
Personal Doctor
Percentage of members rated their primary care physician as an 8, 9, or 10 on a scale of 0-10 with 0 meaning the worst possible and 10 meaning the best possible
Arise Health Plan: 84.00%National Average: 82.75%- Specialist
Specialist
For those members who needed specialty care, the percentage of members who rated their specialist as an 8, 9, or 10 on a scale of 0-10 with 0 meaning the worst possible and 10 meaning the best possible.
Arise Health Plan: 83.98%National Average: 82.02%- Shared Decision Making
Shared Decision Making
Percentage of members responded that their doctor discussed pros & cons of treatment choices and asked what treatement choice was best for the member
Arise Health Plan: 60.73%National Average: 61.45%- Doctors Communicate
Doctors Communicate
Percentage of members responded usually or always their personal doctor's explanation of things was easy to understnd, showed respect for what the member had to say and spent enough time with the member
Arise Health Plan: 96.15%National Average: 93.86%
- Getting Needed Care
Getting Needed Care
Percentage of members responded it was easy to get the care, tests, or treatments needed and to get appointments with specialists
Arise Health Plan: 89.53%National Average: 86.47%- Getting Care Quickly
Getting Care Quickly
Percentage of members responded they got urgent care as needed, got regular/routine appointments as soon as needed
Arise Health Plan: 87.79%National Average: 86.77%- Smoking-Tobacco Use
Smoking-Tobacco Use
Medical assistance with smoking and tobacco use cessation
Arise Health Plan: 9.01%National Average: 13.68%- Flu Shot - Adults
Flu Shot - Adults
Members aged 50 to 64 who received a flu shot
Arise Health Plan: 47.49%National Average: 52.03%- Claims Processing
Claims Processing
Percentage of members responded that claims were usually or always handled quickly and correctly
Arise Health Plan: 92.11%National Average: 88.33%- Customer Service
Customer Service
Percentage of members responded that they usually or always received needed information from Member Services and that they were treated with courtesy and respect.
Arise Health Plan: 87.69%National Average: 83.93%
2011 HEDIS® Performance Data
HEDIS® compares the performance of different health plans on a broad range of important health issues. This information helps employers, individuals, and families determine which plan may be best for them.
Click on the blue tabs below and view our recent results.
2011 HEDIS® Customer Service
- Call Abandonment
Call Abandonment
Percentage of calls received by the health plan that were abandoned by the caller - lower is better
Arise Health Plan: 0.93%National Average: 2.73%- Call Timeliness
Call Timeliness
Percentage of calls received by the health plan that were answered by a live voice within 30 seconds
Arise Health Plan: 92.46%National Average: 77.52%
2011 HEDIS® Access to Care
- Children (12 to 24 mo)
Children (12 to 24 mo)
Percentage of members who had a visit with a Primary Care Practitioner
Arise Health Plan: 98.10%National Average: 97.50%- Children (25 mo to 6 yrs)
Children (25 mo to 6 yrs)
Percentage of members who had a visit with a Primary Care Practitioner
Arise Health Plan: 90.38%National Average: 91.43%- Children (7 to 11 yrs)
Children (7 to 11 yrs)
Percentage of members who had a visit with a Primary Care Practitioner
Arise Health Plan: 91.24%National Average: 91.84%- Children (12 to 19 yrs)
Children (12 to 19 yrs)
Percentage of members who had a visit with a Primary Care Practitioner
Arise Health Plan: 85.82%National Average: 89.29%- Adults (20 to 44 yrs)
Adults (20 to 44 yrs)
Percentage of members who had a visit with a medical practitioner
Arise Health Plan: 94.92%National Average: 93.72%- Adults (45 to 64 yrs)
Adults (45 to 64 yrs)
Percentage of members who had a visit with a medical practitioner
Arise Health Plan: 96.43%National Average: 95.61%- Adults (age 65+)
Adults (age 65+)
Percentage of members who had a visit with a medical practitioner
Arise Health Plan: 97.64%National Average: 97.00%
2011 HEDIS® Behavioral and Mental Health
- 7 Day Follow Up
7 Day Follow Up
Follow Up After Hospitalization for Mental Illness within 7 days
Arise Health Plan: 75.00%National Average: 59.71%- 30 Day Follow Up
30 Day Follow Up
Follow up after hospitalization for mental illness within 30 days
Arise Health Plan: 88.33%National Average: 77.66%- Acute Medication
Acute Medication
Percentage of members diagnosed with major depression who remained on an antidepressant medication for 84 days
Arise Health Plan: 73.88%National Average: 64.09%- Continuation Medication
Continuation Medication
Percentage of members diagnosed with major depression who remained on an antidepressant medication for 180 days
Arise Health Plan: 61.22%National Average: 48.03%- Treatment Initiation
Treatment Initiation
Percentage of members diagnosed with alcohol or other drug dependence who received treatment within 14 days of diagnosis.
Arise Health Plan: 39.57%National Average: 43.69%- Treatment Engagement
Treatment Engagement
Percentage of members diagnosed with alcohol or other drug dependence who received additional services within 30 days after initial visit
Arise Health Plan: 16.60%National Average: 16.26%
2011 HEDIS® Cancer Screening
- Breast Screening
Breast Screening
Percentage of women age 40-69 who had a mammogram to screen for breast cancer
Arise Health Plan: 78.86%National Average: 70.26%- Cervical Screening
Cervical Screening
Percentage of women age 21-64 who received one or more Pap tests to screen for cervical cancer
Arise Health Plan: 79.58%National Average: 76.93%- Colorectal Screening
Colorectal Screening
Percentage of members age 50-75 who had appropriate screening for colorectal cancer
Arise Health Plan: 73.41%National Average: 62.27%
2011 HEDIS® Cardiac Care
- High Blood Pressure
High Blood Pressure
Percentage of members diagnosed with high blood pressure who now have a controlled level
Arise Health Plan: 68.69%National Average: 63.50%- LDL Screening
LDL Screening
Percentage of members with heart conditions who have had their LDL cholesterol checked
Arise Health Plan: 89.88%National Average: 88.99%- LDL C (below 100mg/dl)
LDL C (below 100mg/dl)
Percentage of members with heart conditions whose LDL cholesterol is <100mg/dl
Arise Health Plan: 73.93%National Average: 60.36%
2011 HEDIS® Child & Adolescent Care
- Babies
Babies
Percentage of babies who received 6 or more visits in the 1st 15 months of life
Arise Health Plan: 83.40%National Average: 76.54%- Children
Children
Percentage of children who received well child visits in the 3rd, 4th, 5th & 6th years of life
Arise Health Plan: 76.75%National Average: 72.74%- Adolescents
Adolescents
Percentage of adolescents who received a well visit
Arise Health Plan: 37.00%National Average: 44.14%- Upper Respiratory
Upper Respiratory
Appropriate treatment for children with upper respiratory infection
Arise Health Plan: 93.10%National Average: 85.23%- Pharyngitis
Pharyngitis
Appropriate testing for children with pharyngitis
Arise Health Plan: 73.36%National Average: 78.31%- ADHD
ADHD
Percentage of members age 6-12 newly diagnosed with ADHD who had a follow up visit within 30 days
Arise Health Plan: 45.35%National Average: 39.40%- Weight Assessment
Weight Assessment
Percentage of members age 3-17 who had their BMI percentile measured during a visit
Arise Health Plan: 70.07%National Average: 31.61%- Nutrition
Nutrition
Percentage of members age 3-17 who received counseling for nutrition
Arise Health Plan: 69.59%National Average: 35.66%- Physical Activity
Physical Activity
Percentage of members age 3-17 who received counseling for physical activity
Arise Health Plan: 63.75%National Average: 32.83%
2011 HEDIS® Childhood Immunizations
- DTaP
DTaP
Dtap (diphtheria, tetanus and acellular pertussis) vaccine
Arise Health Plan: 90.45%National Average: 86.81%- Hepatitis B
Hepatitis B
Hepatitis B vaccine
Arise Health Plan: 89.49%National Average: 90.75%- H Influenza
H Influenza
H influenza type B vaccine
Arise Health Plan: 95.54%National Average: 94.94%- MMR
MMR
Measles, mumps and rubella (MMR) vaccine
Arise Health Plan: 86.31%National Average: 91.08%- Polio
Polio
Polio vaccine
Arise Health Plan: 94.59%National Average: 92.19%- Chicken Pox
Chicken Pox
Chicken pox vaccine
Arise Health Plan: 91.72%National Average: 91.10%- Pneumococcal
Pneumococcal
Pneumococcal conjugate vaccine
Arise Health Plan: 92.04%National Average: 86.05%- Rotovirus
Rotovirus
Rotovirus vaccine
Arise Health Plan: 78.66%National Average: 62.77%- Influenza A
Influenza A
Influenza A vaccine
Arise Health Plan: 66.24%National Average: 57.59%- Hepatitis A
Hepatitis A
Hepatitis A vaccine
Arise Health Plan: 46.50%National Average: 33.23%
2011 HEDIS® Adolescent Immunizations
- Meningococcal
Meningococcal
Percentage of adolescents 13 years of age who had one dose of meningococcal vaccine by their 13th birthday.
Arise Health Plan: 54.52%National Average: 54.06%- Tdap/Td
Tdap/Td
Percentage of adolescents 13 years of age who had one tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap) or one tetanus, diphtheria toxoids vaccine (Td) by their 13th birthday.
Arise Health Plan: 92.18%National Average: 68.81%
2011 HEDIS® Diabetes Care
- HbA1c Screening
HbA1c Screening
Percentage of diabetic members who had a HbA1c test
Arise Health Plan: 94.80%National Average: 89.89%- HbA1c (above 9%)
HbA1c (above 9%)
Percentage of diabetic members whose HbA1c result is greater than 9.0% - lower rate is better
Arise Health Plan: 13.57%National Average: 26.69%- HgA1c (below 8%)
HgA1c (below 8%)
Percentage of diabetic members whose HbA1c result is less than 8.0%
Arise Health Plan: 73.79%National Average: 63.04%- HgA1c (below 7%)
HgA1c (below 7%)
Percentage of diabetic members whose HbA1c result is less than 7.0%
Arise Health Plan: 53.00%National Average: 43.24%- LDL-C (below 100mg/dl)
LDL-C (below 100mg/dl)
Percentage of diabetic members whose LDL cholesterol is <100mg/dl
Arise Health Plan: 62.08%National Average: 47.53%- Kidney Monitoring
Kidney Monitoring
Percentage of diabetic members screened for kidney disease
Arise Health Plan: 83.64%National Average: 83.32%- Eye Exam
Eye Exam
Percentage of diabetic members received an eye exam for retinal disease
Arise Health Plan: 70.63%National Average: 57.10%- BP (below 140/80)
BP (below 140/80)
Percentage of diabetic members with a blood pressure <140/80
Arise Health Plan: 54.28%National Average: 0.00%- BP (below 140/90)
BP (below 140/90)
Percentage of diabetic members with a blood pressure <140/90
Arise Health Plan: 75.84%National Average: 65.21%
2011 HEDIS® Other Types of Care
- Prenatal Care
Prenatal Care
Percentage of pregnant women who received a prenatal care visit within the first trimester of their pregnancy
Arise Health Plan: 97.47%National Average: 91.11%- Postpartum Care
Postpartum Care
Percentage of women who delivered a baby had a timely postpartum visit
Arise Health Plan: 92.93%National Average: 80.54%- Adult BMI
Adult BMI
Percentage of members age 18-74 who had their BMI measured during a practitioner visit
Arise Health Plan: 76.98%National Average: 36.26%- Imaging Studies
Imaging Studies
Use of imaging for low back pain - higher is better
Arise Health Plan: 79.64%National Average: 74.00%- Antibiotic Avoidance
Antibiotic Avoidance
Avoidance of antibiotic treatment in the adults with acute bronchitis
Arise Health Plan: 24.00%National Average: 21.14%- Spirometry
Spirometry
Use of spirometry testing in the assessment and diagnosis of COPD
Arise Health Plan: 44.44%National Average: 41.38%- Asthma - 5-50 years
Asthma - 5-50 years
Use of appropriate medications for people with asthma - age 5-50 years
Arise Health Plan: 94.12%National Average: 92.93%- Asthma - 12-50 years
Asthma - 12-50 years
Use of appropriate medications for people with asthma - age 12-50 years
Arise Health Plan: 92.63%National Average: 91.87%
CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). HEDIS® is a registered trademark of NCQA.
