UnitedHealthcare of the Midwest, Inc. dba UnitedHealthcare Community Plan (KS) is the top-rated Medicaid HMO plan in Kansas, with a rating of 4 out of 5. This was announced as part of the National Committee for Quality Assurance (NCQA) 2022 Health Plan Ratings.
The annual list evaluates commercial, Medicare and Medicaid health plans based on the quality of patient care, how happy patients are with their care, and health plans’ efforts to keep improving. UnitedHealthcare Community Plan of Kansas was also the top-rated Medicaid HMO plan in Kansas in 2021, with a rating of 4 out of 5.
Ratings of Patient Experience, Prevention and Treatment
The 2022 Health Plan Ratings detail a plan’s ratings in three overall areas: Patient Experience, Prevention and Treatment. Within those categories are specific measures rated 0 to 5. Here are examples of detailed ratings in these three areas for UnitedHealthcare Community Plan of Kansas:
- Overall Patient Experience: 4 out of 5
- Getting Care Quickly: 4 out of 5
- Getting Care Easily: 4 out of 5
- Rating of Primary Care Doctors: 4 out of 5
- Rating of Health Plan: 4 out of 5
- Rating of Care: 4 out of 5
- Prevention: 3 out of 5
- Women’s Reproductive Health: 4.5 stars out of 5
- Treatment: 3.5 out of 5
- Diabetes: 4 out of 5
- Heart Disease: 4 out of 5
- Readmissions: 5 out of 5
Ratings Based on Care Outcomes, Experience and Measures of Clinical Quality
The 2022 Health Plan Ratings are based on data from calendar year 2021. Each year, NCQA rates health plans that choose to publicly report Healthcare Effectiveness Data and Information Set (HEDIS®) results.
NCQA ratings are based on almost 50 assessments of patient care outcomes and experience, including measures of clinical quality from NCQA’s HEDIS and CMS’s Health Outcomes Survey; measures of patient experience using the Consumer Assessment of Healthcare Providers and Systems (CAHPS®); and NCQA’s review of health plan quality improvement processes (NCQA Accreditation).
HEDIS is one of health care’s most widely used performance improvement tools and includes more than 90 measures across 6 domains of care:
- 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
CAHPS is a tool for collecting standardized information on members’ experiences with health plans and their services. This includes items such as provider communication skills and ease of access to services.
NCQA Health Plan Accreditation is a widely recognized, evidence-based program dedicated to quality improvement and measurement. It provides a comprehensive framework for organizations to align and improve operations in areas that are most important to states, employers and consumers.
The National Committee for Quality Assurance (NCQA) is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and recognizes clinicians in key clinical areas. NCQA’s HEDIS is the most widely used performance measurement tool in health care. NCQA’s website (www.ncqa.org) contains information to help consumers, employers and others make informed health care choices.
Advancing Health Care Quality
Transparent health care quality reports are a valuable way to highlight top performers and drive improvement. By measuring and holding health plans accountable to sets of quality measures, health plan ratings also create better health care for consumers.
Organizations can use data from the reports to analyze what is working well and develop plans that help patients achieve superior outcomes and experience.