Quality

The Quality Improvement Program* describes how Vivida Health works to improve member health by providing high quality health care. We can achieve this through:

  • Checking our provider network to make sure you have access to qualified PCPs and specialists.
  • Helping members schedule doctor visits
  • Promoting patient safety through member and provider education
  • Taking action when quality care has not been provided
  • Review of quality care through the Healthcare Effectiveness Data and Information Set (HEDIS®) scores which tell us if members are receiving the type of care they need. Check out our HEDIS® results here.
  • Review of member satisfaction through the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey scores. These scores tell us if you are happy with your care, providers, and the plan. Check out our CAHPS® results here.

*You may call Member Services or talk to your case manager to request a printed copy of our Quality Improvement Program.

HEDIS®

Vivida Health uses the Healthcare Effectiveness Data and Information Set (HEDIS®) scores to assess if members are getting the type of care they need. HEDIS is completed each year. The plan’s goal is to be better than the 75th percentile of Medicaid Health Plans in the nation. Vivida’s scores for 2020 are listed in the table below.

Measure Score Goal
Adolescent Well-Care Visits 50.850% 62.77%
Adults’ Access to Preventive or Ambulatory Health Services: Total 62.170% 85.10%
Antidepressant Medication Management: Acute NA 56.58%
Measure Score Goal
Antidepressant Medication Management: Continuation NA 41.09%
Adult BMI Assessment NA 93.55%
Breast Cancer Screening NA 63.98%
Cervical Cancer Screening 37.200% 66.18%
Childhood Immunization Status: Combination 2 62.900% 77.13%
Childhood Immunization Status: Combination 3 56.450% 74.45%
Comprehensive Diabetes Care: HbA1c Testing 91.800% 90.51%
Comprehensive Diabetes Care: HbA1c Poor Control 54.100% 32.85%
Comprehensive Diabetes Care: HbA1c Control Less Than 8% 39.340% 55.96%
Comprehensive Diabetes Care: Eye Exam 13.110% 64.72%
Comprehensive Diabetes Care: Medical Attention for Nephropathy 91.800% 91.85%
Controlling High Blood Pressure 60.360% 66.91%
Follow-Up Care for Children Prescribed ADHD Medication: Initiation NA 49.86%
Follow-Up Care for Children Prescribed ADHD Medication: Continuation and Maintenance NA 62.69%
Immunizations for Adolescents: Combination 1 53.330% 86.37%
Chlamydia Screening in Women: Total 55.080% 66.29%
Prenatal Care 77.780% 87.59%
Postpartum Care 71.300% 69.83%
Asthma Medication Ratio: Total NA 68.42%
Well-Child Visits in the First 15 Months of Life: 6 or More Visits NA 69.83%
Well-Child Visits: 3rd, 4th, 5th, and 6th Years of Life 72.260% 78.46%
Children and Adolescents Access to PCPs: 12-24 Months 91.320% 97.04%
Children and Adolescents Access to PCPs: 25 Months – 6 Years 82.560% 90.32%
Children and Adolescents Access to PCPs: 7-11 Years NA 93.41%
Children and Adolescents Access to PCPs: 12-19 Years NA 92.45%
Initiation and Engagement of Treatment for Alcohol and Other Drug Dependence: Initiation Total 45.760% 46.68%
Initiation and Engagement of Treatment for Alcohol and Other Drug Dependence: Engagement Total 15.250% 18.45%
Ambulatory Care: Outpatient Visits 264.46 407.56%
Ambulatory Care: ED Visits 62.74 67.49%
Lead Screening in Children 56.450% 81.02%
Adherence to Antipsychotic Meds for Individuals With Schizophrenia NA 67.47%
Metabolic Monitoring for Children and Adolescents on Antipsychotics:
Blood Glucose and Cholesterol Testing Total
28.570% 40.90%
Measure Score Goal
Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Total NA 66.58%
Follow-Up After ED Visit for Mental Illness: 7-Day Follow-Up Total 25.000% 50.00%
Follow-Up After ED Visit for Mental Illness: 30-Day Follow-Up 41.670% 64.91%
Follow-Up After ED Visit for Alcohol and Other Drug Dependence:
7-Day Total
18.520% 17.01%
Follow-Up After ED Visit for Alcohol and Other Drug Dependence:
30-Day Total
22.220% 26.69%
Use of Opioids at High Dosage NA 2.27%
Use of Opioids from Multiple Providers: Multiple Prescribers and Multiple Pharmacies 2.630% 2.16%

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

CAHPS®

Vivida Health uses the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) to survey members and asses their satisfaction with care, providers, and the plan. Both the Child CAHPS and Adult CAHPS are completed each year. The plan’s goal is to be better than the 75th percentile of Medicaid Health Plans in the nation. Vivida’s scores for 2020 are listed in the tables below.

Adult CAHPS
Category Score Goal
Getting Needed Care 74.70% 85.50%
Getting Care Quickly 73.80% 85.10%
How Well Doctors Communicate 90.40% 93.40%
Customer Service 89.40% 91.00%
Coordination of Care (Q17) 84.60% 86.40%
Rating of Health Care (Q8) 81.30% 78.10%
Rating of Personal Doctor (Q18) 85.70% 86.40%
Rating of Specialist (Q22) 83.30% 85.20%
Rating of Health Plan (Q28) 75.40% 80.90%
Child CAHPS
Category Score Goal
Getting Needed Care 67.50% 88.00%
Getting Care Quickly 85.10% 92.40%
How Well Doctors Communicate 90.70% 95.70%
Customer Service 94.20% 90.00%
Coordination of Care (Q20) 78.90% 87.20%
Rating of Health Care (Q8) 82.50% 90.10%
Rating of Personal Doctor (Q21) 87.70% 92.00%
Rating of Specialist (Q25) 90.90% 89.00%
Rating of Health Plan (Q31) 80.40% 89.40%

CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).

 

Vivida Health is focused on providing options for our members to achieve their health and wellness goals. Our healthy behaviors programs give members the tools they need to be successful. Check out our Health Behaviors Incentive Programs results here. Check out our Health Behaviors Incentive Programs results here.