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2008 Performance Report for Utah Commercial HMOs and Medicaid & CHIP Health Plans, Performance Measures (HEDIS) and Consumer Satisfaction Survey Results (CAHPS)

Since 1994, the mission of the Utah Health Data Committee has been “to support health improvement initiatives through the collection, analysis, and public release of health care information.” Part of that mission includes reporting on various Health Maintenance Organizations (HMOs) and Managed Care Organizations (MCOs). The 2008 Performance Report for Utah Commercial HMOs, Medicaid, and CHIP Health Plans is the 12th such report presented by the Utah Health Data Committee.

This report contains information on four commercial HMOs, two Medicaid HMOs, two Medicaid health plans (Select Access Preferred Provider Network and the fee for service plan), and two Children’s Health Insurance Program (CHIP) HMOs. The four commercial HMOs included in this report represent only a portion of the commercial health plan options that are available in Utah. Only specifically-defined HMOs are required to submit data for this report. However, the four Medicaid health plans and two CHIP HMOs reported here represent all of the coverage options for these populations in Utah. This report contains two types of data, one being quality of care, the second being satisfaction with care.

Data in this report come from two sources representing different aspects of care. The first source of data is the Healthcare Effectiveness Data and Information Set (HEDIS®) collected for measurement year 2007. Utah’s HMOs collect and report HEDIS measures to the Office of Health Care Statistics each year, as required by administrative rule. The second source of data is the 2008 Consumer Assessment of Health Plans Survey (CAHPS®). This survey year only included responses given by parents of children enrolled in the health plans. There is also a section regarding the care of children with chronic conditions. This section compares Medicaid, Commercial, and CHIP HMOs with one another regarding the treatment of children with special health care needs.

The goal of this report is to provide information for consumers, purchasers and insurance plans about the performance of Utah’s commercial and CHIP HMOs, as well as Medicaid health plans. Consumers and those who purchase health care can use the information to help them make decisions about which plan to choose. Health plans can use the information to assist them in improving the care and services they provide to enrollees. About 40% of Utahns who currently have health insurance are covered by one of the health plans in this report.

Many different groups contributed to the data collection, analysis, and writing of this report. These include groups within the Utah Department of Health -- Division of Health Care Financing, Division of Community and Family Health Services, the Utah Health Data Committee -- as well as representatives of the participating HMOs.

Last updated: October 8, 2009