Our member satisfaction level is determined by members like you. We participate in the nationally standardized member satisfaction survey – known as CAHPS – every year.

The Agency for Healthcare Research and Quality and the National Committee for Quality Assurance (NCQA) have developed a health plan member survey called the Consumer Assessment of Healthcare Providers and Systems (CAHPS). CAHPS is a tool for measuring health plan member satisfaction.

Across the country, health plans work to achieve a rating of five on a scale of 1 to 5. The survey asks members about:

  • claims processing
  • customer service
  • health care services


It gathers information from members so health plans around the country can compare performance.

For 2019, Prevea360 Health Plan scored a 4 or 5 on the following commercial consumer experience survey questions in NCQA's Private Health Insurance Plan Ratings 2019-2020:

Member Satisfaction Survey
NCQA rating out of 5
Coordination of care
5
Rating of care
5
Getting care easily
4
Rating of primary care doctor
4
Rating of health plan
4


Quality of Care

HEDIS ratings

We use a nationally standardized set of measures called the Healthcare Effectiveness and Data Information Set (HEDIS) to monitor our quality. The measures were created by the National Committee for Quality Assurance (NCQA) so employers, individuals and families have information to compare health plans' performance.

More than 90% of all health insurance companies utilize HEDIS as a trusted source of standardized measures. The NCQA is an independent, not-for-profit organization that evaluates health plans based on more than 50 standards of care and service to determine each health insurance company’s accreditation status.

For 2019 Prevea360 Health Plan was rated a 4 or 5 out of 5 on the following commercial quality measures in NCQA's Private Health Insurance Plan Ratings 2019-2020: 

Prevention
NCQA rating out of 5
Childhood immunizations
5
Adolescent immunizations
5
Adult BMI Assessment
4
Prenatal care
5
Postpartum care
5
Breast cancer screening
4
Colorectal cancer screening
5
Cervical cancer screening
4



Treatment
NCQA rating out of 5
Asthma drug management
4
Diabetes - Blood pressure control
5
Diabetes - Eye exams
5
Diabetes - Glucose control
4
Patients with diabetes or cardiovascular disease receive and staying on statins
5
Controlling high blood pressure
5
Depression - Adhering to medications
5
Appropriate antibiotic use, adults with acute bronchitis
4
Appropriate testing and care for children with a sore throat
4
Use of imaging studies for low back pain
4
Avoiding opioids from multiple prescribers/pharmacies
4
Bronchodilator after hospitalization for acute COPD
4
Appropriate antibiotic use for children with colds
4