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Commercial HMO Quality and Access of Care

HMOs are a form of managed health care in which the health plan coordinates the care an individual may require. This care occurs using a network of doctors, hospitals, and clinics. The prices are fixed and help keep the costs of health care lower.

Performance measures represent two to four questions asked in the survey. These questions are on a scale that includes “always”, “sometimes”, “usually”, or “never ”.

The graphs represent the percentage of health plan members who gave their health plan a score of “usually” or” always” on this measure.



Getting Care Quickly:

What does this measure?

This measure asks enrollees how often they received care as quickly as they wanted.

How is it measured?

This measure was created by combining different questions about “getting care quickly”; enrollees replied with “always”, “sometimes”, “usually”, or “never ”.

About the graph:

The graph represents the percentage of health plan members who gave their health plan a score of “usually” or” always” on this measure.


PEHP, 94.23; SelectHealth, 94.08; State Average, 93.21; Altius, 91.33; National Average, 86.25

Getting Needed Care

What does this measure?

This measure asked enrollees how often they received the care they needed.

How is it measured?

This measure was created by combining different questions about getting needed care. Enrollees reply with “always”, “sometimes”, “usually”, or “never ”.

About the graph:

The graph represents the percentage of health plan members who gave their health plan a score of “usually” or” always” on this measure.

 

SelectHealth, 88.67; Altius, 88.36; State Average, 87.65; PEHP, 85.91; National Average, 85.72

Doctor's Communication

What does this measure?

This measure asked enrollees how often their personal doctors listened and communicated well.

How is it measured?

This measure was created by combining different questions about how well “doctors communicated with their patients.” Enrollees replied with "always”, “sometimes”, "usually”, or “never ”.

About the graph:

The graph represents the percentage of health plan members who gave their health plan a score of “usually” or” always” on this measure.

PEHP, 97.19; State Average,96.72; Altius, 96.54; SelectHealth, 96.42; National Average, 94.07

Customer Service

What does this measure?

This measure asked how often customer service representatives were helpful and courteous

How is it measured?

This measure was created by combining different questions about how often health plans provide “customer service” well. Enrollees replied “always”, “sometimes”, "usually”, or “never ”.

About the graph:

The graph represents the percentage of health plan members who gave their health plan a score of “usually” or” always” on this measure.

SelectHealth, 95.20; State Average, 87.44; PEHP, 85.99; National Average, 85.82; Altius, 81.13