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Quality

Nothing matters more to Arise Health Plan than providing quality service 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.

2013 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: 61.88%
 
 
National Average: 63.16%
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: 79.69%
 
 
National Average: 76.51%
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: 85.82%
 
 
National Average: 83.62%
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: 83.57%
 
 
National Average: 83.55%
Shared Decision Making

Shared Decision Making

Percentage of members responded that their doctor discussed pros & cons of treatment choices and asked what treatment choice was best for the member

Arise Health Plan: 74.77%
 
 
National Average: 62.40%
Doctors Communicate

Doctors Communicate

Percentage of members responded usually or always their personal doctor's explanation of things was easy to understand, showed respect for what the member had to say and spent enough time with the member

Arise Health Plan: 95.90%
 
 
National Average: 94.39%

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: 90.73%
 
 
National Average: 87.36%
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: 89.65%
 
 
National Average: 85.81%
Smoking-Tobacco Use

Smoking-Tobacco Use

Medical assistance with smoking and tobacco use cessation

Arise Health Plan: 8.98%
 
 
National Average: 12.83%
Flu Shot - Adults

Flu Shot - Adults

Members aged 50 to 64 who received a flu shot

Arise Health Plan: 47.71%
 
 
National Average: 54.42%
Claims Processing

Claims Processing

Percentage of members responded that claims were usually or always handled quickly and correctly

Arise Health Plan: 89.76%
 
 
National Average: 88.44%
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: 92.65%
 
 
National Average: 87.97%

2013 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.

2013 HEDIS® Customer Service

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: 87.23%
 
 
National Average: 78.66%

2013 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: 97.23%
 
 
National Average: 97.94%
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: 91.05%
 
 
National Average: 92.31%
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: 91.08%
 
 
National Average: 92.93%
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: 86.68%
 
 
National Average: 90.01%
Adults (20 to 44 yrs)

Adults (20 to 44 yrs)

Percentage of members who had a visit with a medical practitioner

Arise Health Plan: 93.41%
 
 
National Average: 93.40%
Adults (45 to 64 yrs)

Adults (45 to 64 yrs)

Percentage of members who had a visit with a medical practitioner

Arise Health Plan: 95.21%
 
 
National Average: 95.84%
Adults (age 65+)

Adults (age 65+)

Percentage of members who had a visit with a medical practitioner

Arise Health Plan: 98.11%
 
 
National Average: 97.27%

2013 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: 55.81%
 
 
National Average: 57.57%
30 Day Follow Up

30 Day Follow Up

Follow up after hospitalization for mental illness within 30 days

Arise Health Plan: 88.37%
 
 
National Average: 75.42%
Acute Medication

Acute Medication

Percentage of members diagnosed with major depression who remained on an antidepressant medication for 84 days

Arise Health Plan: 79.42%
 
 
National Average: 69.03%
Continuation Medication

Continuation Medication

Percentage of members diagnosed with major depression who remained on an antidepressant medication for 180 days

Arise Health Plan: 66.06%
 
 
National Average: 53.51%
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: 37.90%
 
 
National Average: 40.13%
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: 13.24%
 
 
National Average: 14.33%

2013 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: 77.17%
 
 
National Average: 69.86%
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: 75.35%
 
 
National Average: 75.51%
Colorectal Screening

Colorectal Screening

Percentage of members age 50-75 who had appropriate screening for colorectal cancer

Arise Health Plan: 70.80%
 
 
National Average: 62.23%

2013 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: 52.07%
 
 
National Average: 61.63%
LDL Screening

LDL Screening

Percentage of members with heart conditions who have had their LDL cholesterol checked

Arise Health Plan: 84.42%
 
 
National Average: 88.13%
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: 64.94%
 
 
National Average: 59.27%

2013 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: 81.88%
 
 
National Average: 78.67%
Children

Children

Percentage of children who received well child visits in the 3rd, 4th, 5th, & 6th years of life

Arise Health Plan: 79.79%
 
 
National Average: 74.36%
Adolescents

Adolescents

Percentage of adolescents who received a well visit

Arise Health Plan: 39.76%
 
 
National Average: 44.76%
Upper Respiratory

Upper Respiratory

Appropriate treatment for children with upper respiratory infection

Arise Health Plan: 90.51%
 
 
National Average: 84.23%
Pharyngitis

Pharyngitis

Appropriate testing for children with pharyngitis

Arise Health Plan: 55.00%
 
 
National Average: 81.22%
ADHD

ADHD

Percentage of members age 6-12 newly diagnosed with ADHD who had a follow up visit within 30 days

Arise Health Plan: 30.67%
 
 
National Average: 38.72%
Weight Assessment

Weight Assessment

Percentage of members age 3-17 who had their BMI percentile measured during a visit

Arise Health Plan: 71.29%
 
 
National Average: 49.34%
Nutrition

Nutrition

Percentage of members age 3-17 who received counseling for nutrition

Arise Health Plan: 68.13%
 
 
National Average: 54.19%
Physical Activity

Physical Activity

Percentage of members age 3-17 who received counseling for physical activity

Arise Health Plan: 65.21%
 
 
National Average: 49.91%

2013 HEDIS® Childhood Immunizations

DTaP

DTaP

Dtap (diphtheria, tetanus and acellular pertussis) vaccine

Arise Health Plan: 88.89%
 
 
National Average: 87.75%
Hepatitis B

Hepatitis B

Hepatitis B vaccine

Arise Health Plan: 88.89%
 
 
National Average: 89.50%
H Influenza

H Influenza

H influenza type B vaccine

Arise Health Plan: 92.98%
 
 
National Average: 94.70%
MMR

MMR

Measles, mumps and rubella (MMR) vaccine

Arise Health Plan: 88.89%
 
 
National Average: 91.78%
Polio

Polio

Polio vaccine

Arise Health Plan: 92.11%
 
 
National Average: 93.14%
Chicken Pox

Chicken Pox

Chicken pox vaccine

Arise Health Plan: 89.18%
 
 
National Average: 91.70%
Pneumococcal

Pneumococcal

Pneumococcal conjugate vaccine

Arise Health Plan: 90.94%
 
 
National Average: 87.42%
Rotovirus

Rotovirus

Rotovirus vaccine

Arise Health Plan: 83.92%
 
 
National Average: 76.96%
Influenza A

Influenza A

Influenza A vaccine

Arise Health Plan: 68.42%
 
 
National Average: 64.08%
Hepatitis A

Hepatitis A

Hepatitis A vaccine

Arise Health Plan: 85.38%
 
 
National Average: 63.04%

2013 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: 60.58%
 
 
National Average: 64.88%
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: 94.40%
 
 
National Average: 78.17%

2013 HEDIS® Diabetes Care

HbA1c Screening

HbA1c Screening

Percentage of diabetic members who had a HbA1c test

Arise Health Plan: 91.06%
 
 
National Average: 89.76%
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: 29.93%
 
 
National Average: 28.85%
HgA1c (below 8%)

HgA1c (below 8%)

Percentage of diabetic members whose HbA1c result is less than 8.0%

Arise Health Plan: 60.04%
 
 
National Average: 61.21%
HgA1c (below 7%)

HgA1c (below 7%)

Percentage of diabetic members whose HbA1c result is less than 7.0%

Arise Health Plan: 35.27%
 
 
National Average: 44.60%
LDL-C (below 100mg/dl)

LDL-C (below 100mg/dl)

Percentage of diabetic members whose LDL cholesterol is <100mg/dl

Arise Health Plan: 48.91%
 
 
National Average: 47.70%
Kidney Monitoring

Kidney Monitoring

Percentage of diabetic members screened for kidney disease

Arise Health Plan: 80.29%
 
 
National Average: 83.70%
Eye Exam

Eye Exam

Percentage of diabetic members received an eye exam for retinal disease

Arise Health Plan: 61.86%
 
 
National Average: 55.70%
BP (below 130/80)

BP (below 130/80)

Percentage of diabetic members with a blood pressure <130/80

Arise Health Plan: 42.88%
 
 
National Average: 42.27%
BP (below 140/90)

BP (below 140/90)

Percentage of diabetic members with a blood pressure <140/90

Arise Health Plan: 64.60%
 
 
National Average: 64.92%

2013 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: 89.30%
 
 
National Average: 89.70%
Postpartum Care

Postpartum Care

Percentage of women who delivered a baby had a timely postpartum visit

Arise Health Plan: 89.91%
 
 
National Average: 80.22%
Adult BMI

Adult BMI

Percentage of members age 18-74 who had their BMI measured during a practitioner visit

Arise Health Plan: 78.83%
 
 
National Average: 64.27%
Imaging Studies

Imaging Studies

Use of imaging for low back pain - higher is better

Arise Health Plan: 79.05%
 
 
National Average: 74.28%
Antibiotic Avoidance

Antibiotic Avoidance

Avoidance of antibiotic treatment in the adults with acute bronchitis

Arise Health Plan: 40.48%
 
 
National Average: 22.26%
Spirometry

Spirometry

Use of spirometry testing in the assessment and diagnosis of COPD

Arise Health Plan: 36.36%
 
 
National Average: 43.34%
Asthma - 19-50 years

Asthma - 19-50 years

Use of appropriate medications for people with asthma - age 19-50 years

Arise Health Plan: 86.81%
 
 
National Average: 88.17%
Asthma - 5-64 years

Asthma - 5-64 years

Use of appropriate medications for people with asthma - age 5-64 years

Arise Health Plan: 91.12%
 
 
National Average: 91.08%

CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). HEDIS® is a registered trademark of NCQA.