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Commercial Quality and Access of Care

Commercial health insurance is defined as any type of health benefit not obtained from Medicare or Medicaid plans. The insurance may be employer-sponsored or privately purchased. Commercial health insurance may be provided on a fee-for-service basis or through a managed care plan.

Performance measures represent two to four questions asked in the survey. These questions are on a scale that includes “always”, “sometimes”, “usually”, or “never ”, or "yes" or "no".

The graphs represent the percentage of health plan members who gave their child's health plan a score of “usually” or” always”, or "yes" 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.


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.

 


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.

Tall Tree : 99.08% ; Regence : 99.04% ; SelectHealth Commercial : 98.98% ; PEHP : 98.94% ; Educators Mutual : 98.70% ; Aetna : 98.03% ; Deseret Mutual : 97.80% ; Meritain : 97.56% ; United : 96.50% ; Humana : 96.37% ; Cigna : 96.08% ; Altius : 96.07% ;

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.

Deseret Mutual : 97.46% ; SelectHealth Commercial : 93.00% ; PEHP : 91.94% ; Educators Mutual : 90.45% ; Meritain : 88.00% ; Tall Tree : 86.84% ; United : 86.37% ; Aetna : 85.91% ; Humana : 83.82% ; Regence : 81.39% ; Altius : 80.49% ; Cigna : 74.33%

Shared Decision Making

What does this measure?

This measure asked enrollees if their health provider discussed medicine options.

How is it measured?

This measure is created by combining different questions about discussions a member may have had with their health care provider about taking medicine. Enrollees replied “yes” or “no”.

About the graph:

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

Deseret Mutual : 87.54% ; Regence : 86.89% ; PEHP : 83.55% ; SelectHealth Commercial : 82.72% ; Meritain : 82.11% ; United : 82.09% ; Humana : 79.43% ; Tall Tree : 79.37% ; Educators Mutual : 75.12% ; Cigna : 71.35% ; Aetna : 69.52% ; Altius : 67.16%