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Wisconsin Department of Employee Trust Funds header image It's Your Choice 2016 State of Wisconsin Group Health Insurance Program
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Wisconsin Department Of Employee Trust Funds It's Your Choice 2016


Local Health Plan
Insurance for Employees
and Retirees
(PO6)


2015 Health Plan Report Card

Individual Measures

The following are the measures that make up the four ratings. Grievances is a stand-alone measure in that it is solely is based on the number of grievances received.

You can click on the measure name to see how health plans perform in that measure.

 

Overall Performance composite

  1. Controlling High Blood Pressure (CBP)
  2. Comprehensive Diabetes Care: Blood Pressure Control (CDC)
  3. Plan All-Cause Readmissions (PCR)
  4. Antidepressant Medication Management (AMM)
  5. Medication Management for People with Asthma (MMA)
  6. Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis (AAB)
  7. Health Plan Rating (survey question #42)
  8. Care Coordination (survey question #22)
  9. Appropriate Testing for Children with Pharyngitis (CWP)

 

Quality composite

  1. Controlling High Blood Pressure (CBP)
  2. Comprehensive Diabetes Care (CDC):
  3. Breast Cancer Screening (BCS)
  4. Colon Cancer Screening (COL)
  5. Medical Assistance with Smoking and Tobacco Cessation:
  6. Health Plan Rating (survey question #42)
  7. Primary Care Physician Rating (survey question #23)
  8. Specialty Care Physician Rating (survey question #27)

 

Care Coordination composite

  1. Ambulatory Care: Emergency Department Visits (AMB)
  2. Plan All-Cause Readmissions (PCR)
  3. Follow-Up After Hospitalization for Mental Illness (FUH)
  4. Antidepressant Medication Management (AMM)
  5. Follow-Up Care for Children Prescribed ADHD Medication (ADD)
  6. Medication Management for People with Asthma (MMA)
  7. Care Coordination (survey question #22)

 

Overuse of Services composite

  1. Appropriate Treatment for Children with Upper Respiratory Infection (URI)
  2. Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis (AAB)
  3. Use of Imaging Studies for Low Back Pain (LBP)
  4. Appropriate Testing for Children with Pharyngitis (CWP)

 

- The measures that come from a survey of health plan members say “survey question” after the name along with the question number

- Measures with three letters after the name are based on data from the health plan

- For more information on the measures and how they are used in the rankings click here

Controlling High Blood Pressure (CBP)

Measure description: 
This is the rate of health plan members with hypertension that have their blood pressure in control (<140/90) in the prior year.

A higher figure means better performance.

Controlling High Blood Pressure (CBP)**

Health Plan Rating
Anthem Blue (all plans)1 77.01%
Arise Health Plan (all plans)2 54.39%
Dean Health Insurance (all plans)3 81.85%
Group Health Cooperative of Eau Claire 69.35%
GHC of South Central Wisconsin 75.91%
Gundersen Health Plan 82.97%
Health Tradition Health Plan 77.32%
HealthPartners Health Plan 75.63%
Humana (all plans)4 76.27%
Medical Associates Health Plans 80.78%
MercyCare Health Plans 64.46%
Network Health5 75.13%
Physicians Plus  68.88%
Security Health Plan 75.91%
UnitedHealthcare of Wisconsin 71.30%
Unity (all plans)6 72.51%
WEA Trust (all plans)7 NR

TABLE KEY

Sort columns by clicking on the header.

 

A higher figure means
better performance.

 

RESOURCES

Meathods UsedReview our methods used for developing these ratings.

Quality resource linksOther Quality Resource links for ratings.

List of MeasuresHealth Plan Features and links to plan description pages.

Comprehensive Diabetes Care: Blood Pressure Control (CDC)

Measure description: 
This is the rate of health plan members with diabetes that have their blood pressure in control (< 140/90 mm Hg) in the prior year.

A higher figure means better performance.

Comprehensive Diabetes Care: Blood Pressure Control (CDC)**

Health Plan Rate
Anthem Blue (all plans)1 80.80%
Arise Health Plan (all plans)2 66.09%
Dean Health Insurance (all plans)3 85.04%
Group Health Cooperative of Eau Claire 87.62%
GHC of South Central Wisconsin 77.55%
Gundersen Health Plan 82.10%
Health Tradition Health Plan 77.64%
HealthPartners Health Plan 83.94%
Humana (all plans)4 75.18%
Medical Associates Health Plans 81.02%
MercyCare Health Plans 68.62%
Network Health5 78.66%
Physicians Plus  66.18%
Security Health Plan 75.73%
UnitedHealthcare of Wisconsin 73.66%
Unity (all plans)6 76.00%
WEA Trust (all plans)7 57.12%

TABLE KEY

Sort columns by clicking on the header.

 

A higher figure means
better performance.

 

RESOURCES

Meathods UsedReview our methods used for developing these ratings.

Quality resource linksOther Quality Resource links for ratings.

Plan All-Cause Readmissions (PCR)

Measure description: 
This is a measure of members being readmitted back to a hospital within 30 days of being discharged from a hospitalization. 

The measure results in the table are risk adjusted rates.  A lower figure means better performance.

Plan All-Cause Readmissions (PCR)**

Health Plan Rate
Anthem Blue (all plans)1 0.6481
Arise Health Plan (all plans)2 0.4157
Dean Health Insurance (all plans)3 0.8365
Group Health Cooperative of Eau Claire 0.4574
GHC of South Central Wisconsin 0.9133
Gundersen Health Plan 0.7007
Health Tradition Health Plan 0.9110
HealthPartners Health Plan 0.6914
Humana (all plans)4 0.6583
Medical Associates Health Plans 0.8224
MercyCare Health Plans 1.2062
Network Health5 0.4838
Physicians Plus  0.7584
Security Health Plan 0.6473
UnitedHealthcare of Wisconsin 0.6858
Unity (all plans)6 0.7987
WEA Trust (all plans)7 0.6387

TABLE KEY

Sort columns by clicking on the header.

 

A lower figure means
better performance.

 

RESOURCES

Meathods UsedReview our methods used for developing these ratings.

Quality resource linksOther Quality Resource links for ratings.

Antidepressant Medication Management (AMM)

Measure description: 
This is the rate of health plan members with major depression taking antidepressants who stayed on the medication for at least six months.

A higher figure means better performance.

Antidepressant Medication Management (AMM)**

Health Plan Rate
Anthem Blue (all plans)1 51.22%
Arise Health Plan (all plans)2 67.03%
Dean Health Insurance (all plans)3 58.11%
Group Health Cooperative of Eau Claire 52.86%
GHC of South Central Wisconsin 57.08%
Gundersen Health Plan 63.42%
Health Tradition Health Plan 46.88%
HealthPartners Health Plan 59.91%
Humana (all plans)4 54.76%
Medical Associates Health Plans 50.77%
MercyCare Health Plans 51.11%
Network Health5 53.45%
Physicians Plus  57.53%
Security Health Plan 57.98%
UnitedHealthcare of Wisconsin 52.08%
Unity (all plans)6 54.00%
WEA Trust (all plans)7 58.96%

TABLE KEY

Sort columns by clicking on the header.

 

A higher figure means
better performance.

 

RESOURCES

Meathods UsedReview our methods used for developing these ratings.

Quality resource linksOther Quality Resource links for ratings.

Follow-Up Care for Children Prescribed ADHD Medication (ADD)

Measure description: 
The measure is in regard to children prescribed attention-deficit/hyperactivity disorder (ADHD) medication.  For these children, the measure is the rate who stayed on ADHD medications at least seven months and also had follow up visits.

A higher figure means better performance.

Follow-Up Care for Children Prescribed ADHD Medication (ADD)**

Health Plan Rate
Anthem Blue (all plans)1 48.65%
Arise Health Plan (all plans)2 NA 
Dean Health Insurance (all plans)3 40.00%
Group Health Cooperative of Eau Claire NA 
GHC of South Central Wisconsin NA 
Gundersen Health Plan NA 
Health Tradition Health Plan NA 
HealthPartners Health Plan 49.54%
Humana (all plans)4 NA 
Medical Associates Health Plans NA 
MercyCare Health Plans NA 
Network Health5 36.67%
Physicians Plus  NA 
Security Health Plan 23.08%
UnitedHealthcare of Wisconsin NA 
Unity (all plans)6 52.50%
WEA Trust (all plans)7 37.04%

TABLE KEY

Sort columns by clicking on the header.

 

A higher figure means
better performance.

 

RESOURCES

Meathods UsedReview our methods used for developing these ratings.

Quality resource linksOther Quality Resource links for ratings.

Medication Management for People with Asthma (MMA)

Measure description: 
This is the rate of health plan members with persistent asthma age 5 to 64 who stayed on their controller medication for at least 75% of the treatment period.

A higher figure means better performance.

Medication Management for People with Asthma (MMA)**

Health Plan Rate
Anthem Blue (all plans)1 42.28%
Arise Health Plan (all plans)2 40.00%
Dean Health Insurance (all plans)3 52.51%
Group Health Cooperative of Eau Claire 42.59%
GHC of South Central Wisconsin 42.12%
Gundersen Health Plan 45.62%
Health Tradition Health Plan 45.34%
HealthPartners Health Plan 48.00%
Humana (all plans)4 42.74%
Medical Associates Health Plans 30.77%
MercyCare Health Plans 52.94%
Network Health5 37.95%
Physicians Plus  47.75%
Security Health Plan 48.58%
UnitedHealthcare of Wisconsin 50.00%
Unity (all plans)6 44.35%
WEA Trust (all plans)7 46.98%

TABLE KEY

Sort columns by clicking on the header.

 

A higher figure means
better performance.

 

RESOURCES

Meathods UsedReview our methods used for developing these ratings.

Quality resource linksOther Quality Resource links for ratings.

Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis (AAB)

Measure description: 
This is the rate of health plan members with acute bronchitis who did not receive an antibiotic prescription.  Such prescriptions to treat people with bronchitis should be avoided.

A higher figure means better performance.

Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis (AAB)**

Health Plan Rate
Anthem Blue (all plans)1 23.24%
Arise Health Plan (all plans)2 36.51%
Dean Health Insurance (all plans)3 29.12%
Group Health Cooperative of Eau Claire 25.93%
GHC of South Central Wisconsin 62.92%
Gundersen Health Plan 43.17%
Health Tradition Health Plan 22.82%
HealthPartners Health Plan 37.39%
Humana (all plans)4 20.74%
Medical Associates Health Plans 18.38%
MercyCare Health Plans 23.53%
Network Health5 22.55%
Physicians Plus  32.41%
Security Health Plan 25.17%
UnitedHealthcare of Wisconsin 20.22%
Unity (all plans)6 27.32%
WEA Trust (all plans)7 25.02%

TABLE KEY

Sort columns by clicking on the header.

 

A higher figure means
better performance.

 

RESOURCES

Meathods UsedReview our methods used for developing these ratings.

Quality resource linksOther Quality Resource links for ratings.

Health Plan Rating (survey question #42)

Measure description: 
In a survey of adult, commercially insured health plan members they were asked the question:  “Using any number from 0 to 10, where 0 is the worst health plan possible and 10 is the best health plan possible, what number would you use to rate your health plan?“.

The result reported is the rate of people that responded with a “9” or “10”.

A higher figure means better performance.

Health Plan Rating
(survey question #42)*

Health Plan Rate
Anthem Blue (all plans)1 23.68%
Arise Health Plan (all plans)2 32.72%
Dean Health Insurance (all plans)3 41.45%
Group Health Cooperative of Eau Claire 48.79%
GHC of South Central Wisconsin 50.97%
Gundersen Health Plan 37.83%
Health Tradition Health Plan 39.34%
HealthPartners Health Plan 39.52%
Humana (all plans)4 31.60%
Medical Associates Health Plans 54.84%
MercyCare Health Plans 33.33%
Network Health5 41.18%
Physicians Plus  40.77%
Security Health Plan 35.80%
UnitedHealthcare of Wisconsin 36.14%
Unity (all plans)6 50.00%
WEA Trust (all plans)7 50.43%

TABLE KEY

Sort columns by clicking on the header.

 

A higher figure means
better performance.

 

RESOURCES

Meathods UsedReview our methods used for developing these ratings.

Quality resource linksOther Quality Resource links for ratings.

Care Coordination (survey question #22)

Measure description: 
In a survey of adult, commercially insured health plan members they were asked the question:  “In the last 12 months, how often did your personal doctor seem informed and up-to-date about the care you got from these doctors or other health providers?”

The response options were “never”, “sometimes”, “usually” and “always”.  The result reported is the rate of people that said “always”.

A higher figure means better performance.

Care Coordination
(survey question #22)*

Health Plan Rate
Anthem Blue (all plans)1 59.02%
Arise Health Plan (all plans)2 57.86%
Dean Health Insurance (all plans)3 60.32%
Group Health Cooperative of Eau Claire 52.75%
GHC of South Central Wisconsin 47.92%
Gundersen Health Plan 64.80%
Health Tradition Health Plan 56.14%
HealthPartners Health Plan 56.63%
Humana (all plans)4 57.60%
Medical Associates Health Plans 51.42%
MercyCare Health Plans 48.81%
Network Health5 52.87%
Physicians Plus  53.54%
Security Health Plan 50.61%
UnitedHealthcare of Wisconsin 53.46%
Unity (all plans)6 56.79%
WEA Trust (all plans)7 52.78%

TABLE KEY

Sort columns by clicking on the header.

 

A higher figure means
better performance.

 

RESOURCES

Meathods UsedReview our methods used for developing these ratings.

Quality resource linksOther Quality Resource links for ratings.

Appropriate Testing for Children with Pharyngitis (CWP)

Measure description:
This is the rate of children with pharyngitis who received a strep test before receiving an antibiotic prescription.  Such prescriptions should only happen if a strep test occurred.

A higher figure means better performance.

Appropriate Testing for Children with Pharyngitis (CWP)**

Health Plan Rate
Anthem Blue (all plans)1 79.10%
Arise Health Plan (all plans)2 57.00%
Dean Health Insurance (all plans)3 82.13%
Group Health Cooperative of Eau Claire 87.14%
GHC of South Central Wisconsin 93.54%
Gundersen Health Plan 85.54%
Health Tradition Health Plan 90.98%
HealthPartners Health Plan 93.68%
Humana (all plans)4 74.20%
Medical Associates Health Plans 82.06%
MercyCare Health Plans 77.14%
Network Health5 69.21%
Physicians Plus  87.07%
Security Health Plan 83.81%
UnitedHealthcare of Wisconsin 72.66%
Unity (all plans)6 87.06%
WEA Trust (all plans)7 80.23%

TABLE KEY

Sort columns by clicking on the header.

 

A higher figure means
better performance.

 

RESOURCES

Meathods UsedReview our methods used for developing these ratings.

Quality resource linksOther Quality Resource links for ratings.

Comprehensive Diabetes Care (CDC): Blood Sugar Control

Measure description: 
This is the rate of health plan members with diabetes that have their blood sugar in control (< 8%) in the prior year.

A higher figure means better performance.

Comprehensive Diabetes Care (CDC): Blood Sugar Control**

Health Plan Rating
Anthem Blue (all plans)1 64.59%
Arise Health Plan (all plans)2 52.48%
Dean Health Insurance (all plans)3 68.07%
Group Health Cooperative of Eau Claire 72.28%
GHC of South Central Wisconsin 59.31%
Gundersen Health Plan 65.10%
Health Tradition Health Plan 62.56%
HealthPartners Health Plan 67.52%
Humana (all plans)4 60.83%
Medical Associates Health Plans 74.17%
MercyCare Health Plans 59.95%
Network Health5 72.77%
Physicians Plus  48.18%
Security Health Plan 68.98%
UnitedHealthcare of Wisconsin 62.00%
Unity (all plans)6 67.00%
WEA Trust (all plans)7 47.08%

TABLE KEY

Sort columns by clicking on the header.

 

A higher figure means
better performance.

 

RESOURCES

Meathods UsedReview our methods used for developing these ratings.

Quality resource linksOther Quality Resource links for ratings.

Breast Cancer Screening (BCS)

Measure description: 
This is the rate of health plan members who are women age 50 - 74 that had a mammogram to screen for breast cancer.

A higher figure means better performance.

Breast Cancer Screening (BCS)**

Health Plan Rate
Anthem Blue (all plans)1 74.03%
Arise Health Plan (all plans)2 71.05%
Dean Health Insurance (all plans)3 79.03%
Group Health Cooperative of Eau Claire 81.59%
GHC of South Central Wisconsin 80.27%
Gundersen Health Plan 81.75%
Health Tradition Health Plan 82.90%
HealthPartners Health Plan 78.74%
Humana (all plans)4 77.47%
Medical Associates Health Plans 82.92%
MercyCare Health Plans 71.86%
Network Health5 76.81%
Physicians Plus  80.97%
Security Health Plan 84.68%
UnitedHealthcare of Wisconsin 73.42%
Unity (all plans)6 82.70%
WEA Trust (all plans)7 82.47%

TABLE KEY

Sort columns by clicking on the header.

 

A higher figure means
better performance.

 

RESOURCES

Meathods UsedReview our methods used for developing these ratings.

Quality resource linksOther Quality Resource links for ratings.

Colon Cancer Screening (COL)

Measure description: 
This is the rate of health plan members 50 - 75 years old that had one of several types of appropriate screens for colon cancer.

A higher figure means better performance.

Colon Cancer Screening (COL)**

Health Plan Rate
Anthem Blue (all plans)1 59.46%
Arise Health Plan (all plans)2 60.17%
Dean Health Insurance (all plans)3 67.09%
Group Health Cooperative of Eau Claire 71.78%
GHC of South Central Wisconsin 71.53%
Gundersen Health Plan 70.80%
Health Tradition Health Plan 69.88%
HealthPartners Health Plan 74.86%
Humana (all plans)4 68.15%
Medical Associates Health Plans 73.97%
MercyCare Health Plans 65.34%
Network Health5 75.24%
Physicians Plus  72.99%
Security Health Plan 71.29%
UnitedHealthcare of Wisconsin 81.68%
Unity (all plans)6 71.29%
WEA Trust (all plans)7 71.29%

TABLE KEY

Sort columns by clicking on the header.

 

A higher figure means
better performance.

 

RESOURCES

Meathods UsedReview our methods used for developing these ratings.

Quality resource linksOther Quality Resource links for ratings.

Medical Assistance with Smoking and Tobacco Cessation: Advising Smokers and Tobacco Users to Quit (survey question #47)

Measure description: 
In a survey of adult, commercially insured health plan members who smoke or use tobacco they were asked the question:  “In the last 12 months, how often were you advised to quit smoking or using tobacco by a doctor or other health provider in your plan?“.

The response options were “never”, “sometimes”, “usually” and “always”.  The result reported is the rate of people that said “sometimes”, “usually” or “always”.

A higher figure means better performance.

Medical Assistance with Smoking and Tobacco Cessation: Advising Smokers and Tobacco Users to Quit
(survey question #47)*

Health Plan Rate
Anthem Blue (all plans)1 NA
Arise Health Plan (all plans)2 NA
Dean Health Insurance (all plans)3 78.43%
Group Health Cooperative of Eau Claire NA
GHC of South Central Wisconsin NA
Gundersen Health Plan 70.69%
Health Tradition Health Plan 72.57%
HealthPartners Health Plan NA
Humana (all plans)4 NA
Medical Associates Health Plans 78.77%
MercyCare Health Plans 82.88%
Network Health5 79.34%
Physicians Plus  NA
Security Health Plan NA
UnitedHealthcare of Wisconsin 65.77%
Unity (all plans)6 NA
WEA Trust (all plans)7 NA

TABLE KEY

Sort columns by clicking on the header.

 

A higher figure means
better performance.

 

RESOURCES

Meathods UsedReview our methods used for developing these ratings.

Quality resource linksOther Quality Resource links for ratings.

Medical Assistance with Smoking and Tobacco Cessation: Discussing Cessation Medications (survey question #48)

Measure description: 
In a survey of adult, commercially insured health plan members who smoke or use tobacco they were asked the question:  “In the last 12 months, how often was medication recommended or discussed by a doctor or health provider to assist you with quitting smoking or using tobacco?“.

The response options were “never”, “sometimes”, “usually” and “always”.  The result reported is the rate of people that said “sometimes”, “usually” or “always”.

A higher figure means better performance.

Medical Assistance with Smoking and Tobacco Cessation: Discussing Cessation Medications
(survey question #48)*

Health Plan Rate
Anthem Blue (all plans)1 NA
Arise Health Plan (all plans)2 NA
Dean Health Insurance (all plans)3 52.83%
Group Health Cooperative of Eau Claire NA
GHC of South Central Wisconsin NA
Gundersen Health Plan 48.25%
Health Tradition Health Plan 52.63%
HealthPartners Health Plan NA
Humana (all plans)4 NA
Medical Associates Health Plans 53.38%
MercyCare Health Plans 60.19%
Network Health5 53.33%
Physicians Plus  NA
Security Health Plan NA
UnitedHealthcare of Wisconsin 49.11%
Unity (all plans)6 NA
WEA Trust (all plans)7 NA

TABLE KEY

Sort columns by clicking on the header.

 

A higher figure means
better performance.

 

RESOURCES

Meathods UsedReview our methods used for developing these ratings.

Quality resource linksOther Quality Resource links for ratings.

Medical Assistance with Smoking and Tobacco Cessation: Discussing Cessation Strategies (survey question #49)

Measure description: 
In a survey of adult, commercially insured health plan members who smoke or use tobacco they were asked the question:  “In the last 12 months, how often did your doctor or health provider discuss or provide methods and strategies other than medication to assist you with quitting smoking or using tobacco?”

The response options were “never”, “sometimes”, “usually” and “always”.  The result reported is the rate of people that said “sometimes”, “usually” or “always”.

A higher figure means better performance.

Medical Assistance with Smoking and Tobacco Cessation: Discussing Cessation Strategies
(survey question #49)*

Health Plan Rate
Anthem Blue (all plans)1 NA
Arise Health Plan (all plans)2 NA
Dean Health Insurance (all plans)3 50.49%
Group Health Cooperative of Eau Claire NA
GHC of South Central Wisconsin NA
Gundersen Health Plan 49.11%
Health Tradition Health Plan 51.75%
HealthPartners Health Plan NA
Humana (all plans)4 NA
Medical Associates Health Plans 46.94%
MercyCare Health Plans 50.91%
Network Health5 46.61%
Physicians Plus  NA
Security Health Plan NA
UnitedHealthcare of Wisconsin 47.32%
Unity (all plans)6 NA
WEA Trust (all plans)7 NA

TABLE KEY

Sort columns by clicking on the header.

 

A higher figure means
better performance.

 

RESOURCES

Meathods UsedReview our methods used for developing these ratings.

Quality resource linksOther Quality Resource links for ratings.

Primary Care Physician Rating (survey question #23)

Measure description: 
In a survey of adult, commercially insured health plan members they were asked the question:  “Using any number from 0 to 10, where 0 is the worst personal doctor possible and 10 is the best personal doctor possible, what number would you use to rate your personal doctor?”

The result reported is the rate of people that responded with a “9” or “10”.

A higher figure means better performance.

Primary Care Physician Rating
(survey question #23)*

Health Plan Rate
Anthem Blue (all plans)1 65.34%
Arise Health Plan (all plans)2 68.47%
Dean Health Insurance (all plans)3 71.18%
Group Health Cooperative of Eau Claire 72.47%
GHC of South Central Wisconsin 64.14%
Gundersen Health Plan 77.43%
Health Tradition Health Plan 71.17%
HealthPartners Health Plan 75.75%
Humana (all plans)4 62.72%
Medical Associates Health Plans 73.73%
MercyCare Health Plans 73.00%
Network Health5 66.88%
Physicians Plus  64.16%
Security Health Plan 68.69%
UnitedHealthcare of Wisconsin 69.10%
Unity (all plans)6 67.25%
WEA Trust (all plans)7 69.14%

TABLE KEY

Sort columns by clicking on the header.

 

A higher figure means
better performance.

 

RESOURCES

Meathods UsedReview our methods used for developing these ratings.

Quality resource linksOther Quality Resource links for ratings.

Specialty Care Physician Rating (survey question #27)

Measure description: 
In a survey of adult, commercially insured health plan members they were asked the question:  “We want to know your rating of the specialist you saw most often in the last 12 months. Using any number from 0 to 10, where 0 is the worst specialist possible and 10 is the best specialist possible, what number would you use to rate that specialist?”

The result reported is the rate of people that responded with a “9” or “10”.

A higher figure means better performance.

Specialty Care Physician Rating
(survey question #27)*

Health Plan Rate
Anthem Blue (all plans)1 70.80%
Arise Health Plan (all plans)2 60.81%
Dean Health Insurance (all plans)3 65.78%
Group Health Cooperative of Eau Claire 69.50%
GHC of South Central Wisconsin 55.09%
Gundersen Health Plan 64.39%
Health Tradition Health Plan 60.61%
HealthPartners Health Plan 65.75%
Humana (all plans)4 65.35%
Medical Associates Health Plans 72.40%
MercyCare Health Plans 72.68%
Network Health5 66.86%
Physicians Plus  60.00%
Security Health Plan 70.30%
UnitedHealthcare of Wisconsin 70.06%
Unity (all plans)6 63.74%
WEA Trust (all plans)7 65.37%

TABLE KEY

Sort columns by clicking on the header.

 

A higher figure means
better performance.

 

RESOURCES

Meathods UsedReview our methods used for developing these ratings.

Quality resource linksOther Quality Resource links for ratings.

Ambulatory Care: Emergency Department Visits (AMB)

Measure description: 
This is a measure of members using the Emergency Department.  The rates in the table are emergency department visits per 1,000 member years.

A lower figure means better performance.

Ambulatory Care: Emergency Department Visits (AMB)**

Health Plan Rate
Anthem Blue (all plans)1 157.40
Arise Health Plan (all plans)2 134.67
Dean Health Insurance (all plans)3 212.23
Group Health Cooperative of Eau Claire 112.69
GHC of South Central Wisconsin 148.42
Gundersen Health Plan 248.62
Health Tradition Health Plan 161.54
HealthPartners Health Plan 136.24
Humana (all plans)4 175.12
Medical Associates Health Plans 167.17
MercyCare Health Plans 243.36
Network Health5 155.19
Physicians Plus  180.85
Security Health Plan 173.00
UnitedHealthcare of Wisconsin 171.10
Unity (all plans)6 205.22
WEA Trust (all plans)7 178.15

TABLE KEY

Sort columns by clicking on the header.

 

A lower figure means
better performance.

 

RESOURCES

Meathods UsedReview our methods used for developing these ratings.

Quality resource linksOther Quality Resource links for ratings.

Follow Up After Hospitalization for Mental Illness (FUH)

Measure description: 
This measure is in regard to health plan members over age five hospitalized for treatment of certain types of mental illness.  The rate reported are for those who had a follow up appointment with a mental health professional within a week after being discharged from the hospital.

A higher figure means better performance.

Follow Up After Hospitalization for Mental Illness (FUH)**

Health Plan Rate
Anthem Blue (all plans)1 46.15%
Arise Health Plan (all plans)2 NA
Dean Health Insurance (all plans)3 66.67%
Group Health Cooperative of Eau Claire NA
GHC of South Central Wisconsin 80.36%
Gundersen Health Plan 44.44%
Health Tradition Health Plan 41.86%
HealthPartners Health Plan 65.36%
Humana (all plans)4 55.86%
Medical Associates Health Plans NA
MercyCare Health Plans NA
Network Health5 70.43%
Physicians Plus  80.49%
Security Health Plan 58.55%
UnitedHealthcare of Wisconsin 58.54%
Unity (all plans)6 72.80%
WEA Trust (all plans)7 59.43%

TABLE KEY

Sort columns by clicking on the header.

 

A higher figure means
better performance.

 

RESOURCES

Meathods UsedReview our methods used for developing these ratings.

Quality resource linksOther Quality Resource links for ratings.

Appropriate Treatment for Children with Upper Respiratory Infection (URI)

Measure description:
This is the rate of children with upper respiratory infection who were not given an antibiotic prescription. 

A higher figure means better performance.

Appropriate Treatment for Children with Upper Respiratory Infection (URI)**

Health Plan Rate
Anthem Blue (all plans)1 89.42%
Arise Health Plan (all plans)2 95.10%
Dean Health Insurance (all plans)3 92.08%
Group Health Cooperative of Eau Claire 91.67%
GHC of South Central Wisconsin 97.58%
Gundersen Health Plan 94.24%
Health Tradition Health Plan 87.97%
HealthPartners Health Plan 90.73%
Humana (all plans)4 93.10%
Medical Associates Health Plans 71.23%
MercyCare Health Plans 96.23%
Network Health5 93.36%
Physicians Plus  94.12%
Security Health Plan 87.98%
UnitedHealthcare of Wisconsin 86.23%
Unity (all plans)6 91.26%
WEA Trust (all plans)7 89.86%

TABLE KEY

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A higher figure means
better performance.

 

RESOURCES

Meathods UsedReview our methods used for developing these ratings.

Quality resource linksOther Quality Resource links for ratings.

Use of Imaging Studies for Low Back Pain (LBP)

Measure description:
This is the rate of health plan members who did not have an X-ray, MRI or CT scan within four weeks of a complaint of low back pain. 

A higher figure means better performance.

Use of Imaging Studies for Low Back Pain (LBP)**

Health Plan Rate
Anthem Blue (all plans)1 77.50%
Arise Health Plan (all plans)2 79.66%
Dean Health Insurance (all plans)3 83.21%
Group Health Cooperative of Eau Claire 79.82%
GHC of South Central Wisconsin 87.59%
Gundersen Health Plan 76.65%
Health Tradition Health Plan 82.30%
HealthPartners Health Plan 83.74%
Humana (all plans)4 77.17%
Medical Associates Health Plans 86.23%
MercyCare Health Plans 83.26%
Network Health5 79.39%
Physicians Plus  78.32%
Security Health Plan 72.59%
UnitedHealthcare of Wisconsin 80.14%
Unity (all plans)6 80.62%
WEA Trust (all plans)7 81.22%

TABLE KEY

Sort columns by clicking on the header.

 

A higher figure means
better performance.

 

RESOURCES

Meathods UsedReview our methods used for developing these ratings.

Quality resource linksOther Quality Resource links for ratings.

notes:

*The CAHPS Health Plan Survey is a program of the U.S. Agency for Healthcare Research and Quality (AHRQ)
**This is a HEDIS ® measure from the National Committee for Quality Assurance (NCQA)
“NA”:  Not Applicable  -  The health plan followed the specifications but the denominator was too small to report a valid rate
1.2016 ETF participating Anthem plans include Northeast and Southeast
2.2016 ETF participating Arise plans include Arise Health Plan and Arise Health Plan - Aspirus Arise
3.2016 ETF participating Dean plans include Dean Health Insurance and Dean Prevea360
4.2016 ETF participating Humana plans include Eastern and Western
5.2016 ETF participating Network Health plans include Northeast and Southeast.
6.2016 ETF participating Unity plans include Unity-Community and Unity-UW Health
7.2016 ETF participating WEA Trust plans include East, South Central, Northwest Chippewa Valley and Northwest Mayo Clinic Health System

Note: WPS does not submit results for the measures used to create the ratings above.

Disclaimer:
Every effort has been made to ensure that this information is accurate, but may be subject to change. Please note revision dates located at the bottom of each page. In the event of conflicting information, federal law, state statute, state health contracts and/or policies and provisions established by the State of Wisconsin Group Insurance Board shall be followed.

This page was last modified on: 3/11/2016 11:36:02 AM