Blue Cross Complete of Michigan remains one of Michigan's highest-rated Medicaid plans
Blues Medicaid plan ranked No. 2 in Michigan and No. 10 in nation by nationally recognized accreditation organization
Sept. 25, 2013
DETROIT — More than 38,000 people in Livingston, Washtenaw and Wayne counties can feel even more secure in their health care plan knowing that Blue Cross Complete of Michigan, the Blues’ Medicaid HMO, has been ranked the No. 2 Medicaid plan in the state and the No. 10 Medicaid plan in the nation by the National Committee for Quality Assurance. The ranking is out of 131 Medicaid plans nationally. NCQA is a private, nonprofit organization dedicated to improving health care quality.
“Our plan continues to provide the highest level of service and value to our members, and we’re pleased to again be recognized on a national level for the commitment we’ve made to our members,” said Nancy Wanchik, vice president at Blue Cross Blue Shield of Michigan and CEO of the company’s Medicaid program.
Blue Cross Complete has also earned its sixth-consecutive “Excellent” accreditation for a Managed Care Organization, which reflects service and clinical quality that meet or exceed NCQA's rigorous requirements for consumer protection and quality improvement.
NCQA uses a standard set of criteria, including Healthcare Effectiveness Data and Information Set (HEDIS) measures, to rank the health plans in important aspects of care such as improving members health and customer satisfaction. Prevention and treatment measures make up 60 of the total score, consumer satisfaction accounts for 25 percent and NCQA accreditation scores make up the remaining 15 percent of NCQA’s Medicaid Health Insurance Plan Rankings 2013-2014.
“We proactively find ways to give our members the right care at the right time, and make sure their experiences with us are positive. As part of their health care team, we want to make sure they get the preventive care that’s right for them and the right treatment when they need it. The recognition we receive from NCQA reflects how well we meet these goals,” Wanchik says.
Where did the NCQA rankings come from?
NCQA's rankings of the nation’s Medicaid health insurance plans is based on its combined CAHPS®, HEDIS® and NCQA Accreditation standards scores.
CAHPS is the Consumer Assessment of Healthcare Providers and Systems. It is a survey of health plan members’ experiences and services received through their health plan.
HEDIS is a collection of performance metrics that measure the services provided by a health plan collected through a review of administrative data (such as claims or laboratory) or medical records.
NCQA Accreditation refers to scores that plans that have achieved on their NCQA’s Managed Care Organization, Health Plan or New Health Plan accreditation standards.
1 HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
2 CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care.
Contracted by the State of Michigan to provide medical services to eligible Medicaid beneficiaries, Blue Cross Complete arranges for the provision of covered services to Medicaid members in Livingston, Washtenaw and Wayne counties. Blue Cross Complete of Michigan is a nonprofit corporation and independent licensee of the Blue Cross and Blue Shield Association.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.