Our quality commitment
We want to exceed your expectations
Ways we measure quality and keep improving the member experience
Health Tradition Health Plan is continuously working to provide a level of service consistent with the high standards of quality care established by Mayo Clinic Health System. We advance our vision of service to our members in the following ways:
- We participate in formal programs that measure and report our performance in areas identified as key quality metrics.
- We are accredited by an independent organization with extensive quality criteria, a rigorous accreditation process and recurrent reaccreditation requirements.
- We are measured by governmental agencies to gauge achievement of targeted public health objectives within our member populations.
In 2013, Health Tradition Health Plan was awarded Health Plan Accreditation by URAC, the largest independent accrediting body for health care organizations, after an extensive study of the company’s operations.
URAC accreditation is a dynamic process that identifies best practices and promotes high quality performance measures. Organizations that seek to earn accreditation demonstrate their commitment to quality, accountability and customer service, voluntarily undergoing a rigorous and periodic review that evaluates their operations and services. Health plans that earn URAC accreditation are among the best in the nation.
Specifically, URAC’s measures address the following key areas aimed at helping plans deliver safe, high-quality, patient centered, high-value care:
- Wellness and Health Promotion
- Care Coordination
- Medication Safety and Care Compliance
- Rewarding Quality
- Care Delivery through a Patient Centered Health Care Home Network
- Mental Health Parity
- HIPAA Breach Requirements
- Measures — patient centeredness, coordination of care, patient safety, health plan administration, efficiency, effectiveness of care and HIT integration
- Patient Experience of Care (CAHPS® Survey)
- Operational efficiency and quality in administering members’ benefits
The BadgerCare Plus HMO Report Card, Wisconsin Department of Health Services (DHS)
Health Tradition Health Plan and other HMOs are graded annually for care provided to members enrolled in BadgerCare Plus, a Medicaid program administered by the State of Wisconsin. Grades are awarded by the Wisconsin Department of Health Services (DHS) as part of The BadgerCare Plus HMO Report Card.
In the Aprll, 2013 report card, Health Tradition Health Plan was the only health plan in the state to earn an “A” grade for its performance in each of the seven individual measures. In all, sixteen health plans across Wisconsin were rated. Each was held accountable for care categories including treatment of asthma and diabetes, vaccinations, blood lead testing and smoking cessation.
The BadgerCare Plus HMO Report Card is issued annually by the Wisconsin Department of Health Services. It guides BadgerCare-eligible residents in selecting the plan that best supports their health.
This reporting program is called the Healthcare Effectiveness Data and Information Set or HEDIS.® HEDIS provides unbiased quality information. More than 90 percent of health plans across the United States participate in their data collection. We are excited to report that Health Tradition exceeded the HEDIS 2013 National Committee on Quality Assurance (NCQA) national rate in the following measures:
- Childhood Immunizations Status: DTaP/DT, IPV/OPV, MMR, Hepatitis A, Rotavirus, Hepatits B, Influenza, HIB, Pneumococcal Conjugate and Combo 2 (DTaP, IPV, MMR, HiB, Hepatitis B, Varicella)
- Timeliness of Prenatal Care and Postpartum Care
- Cholesterol Management for Patients with Cardiovascular Conditions
- Breast Cancer Screening
- Colorectal Cancer Screening
- Comprehensive Diabetes Care: HbA1c Testing, HbA1c <8%, Eye Exams,
LDL-C Level <100, Nephropathy Monitoring, BP <130/80
- Controlling High Blood Pressure <140/90
- Adolescent Immunizations: Tdap/Td and Meningococcal
- Antidepressant Medication Management: Effective Acute Phase Treatment, Effective Continuation Phase Treatment
CAHPS® Member Satisfaction Survey
Today’s complex and competitive healthcare environment has generated unprecedented demand for tools and information to document healthcare quality. The consumer’s perspective has become an essential aspect of measuring healthcare quality, and CAHPS® Member Satisfaction Survey is recognized as the industry standard for obtaining consumers’ assessment of their health plans. Health Tradition Health Plan contracts with an NCQA-accredited company to conduct our CAHPS® survey annually.