return to summary results
  

NCQA Health Insurance Plan Ratings 2019-2020 - Detail Report (Private)


Plan Name:   United HealthCare Services, Inc. (Idaho) Rating: 3.5
URL: www.uhc.com
States: ID NCQA Accreditation:   Yes
Other Names: Choice Plus; Non-Differential; Options PPO
Lower Performance Higher Performance
≤1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0
 
  Plan Details Score
Add Consumer Satisfaction
3.0
  
Getting care
4.0
Getting care easily
Did members get appointments, preventive care, tests, and treatment easily?
4.0
Getting care quickly
Did members get appointments, preventive care, tests, and treatments promptly?
4.0
Satisfaction with plan physicians
3.0
Rating of primary-care doctor
Did members rate their primary-care doctors high overall?
3.0
Rating of specialists
Did members rate specialists high overall?
NA
Rating of care
Did members rate their care high overall?
3.0
Coordination of care
Were members satisfied with how their primary provider coordinated care with other providers?
NA
Satisfaction with plan services
2.0
Handling claims
Were members satisfied with how their claims were handled?
2.0
Rating of health plan
Did members rate their overall plan services high?
2.0
 
Add Prevention
2.5
  
Children and adolescent well-care
2.5
Childhood immunizations status- combination 10
Did children receive all recommended immunizations by age 2?
2.0
Adolescent immunizations: Combo 2
Did children receive all 3 recommended immunizations by age 13?
3.0
BMI percentile assessment
Did members ages 3 to 17 have their BMI assessed?
3.0
Women’s reproductive health
3.0
Prenatal checkups
Did pregnant women have a prenatal visit in their first trimester or shortly after enrolling in a health insurance plan?
3.0
Postpartum care
Did women who gave birth have a postpartum visit three to eight weeks after delivery?
3.0
Cancer screening
2.0
Breast cancer screening
Did women ages 50 to 74 get mammograms every two years?
1.0
Colorectal cancer screening
Were members ages 50 to 75 screened for colorectal cancer?
3.0
Cervical cancer screening
Did women ages 21 to 64 receive cervical cancer screening?
2.0
Other preventive services
Adult BMI assessment
Did adult members ages 18 to 74 have their BMI assessed?
4.0
Chlamydia screening
Did sexually active women ages 16 to 24 get tested for chlamydia?
1.0
Flu shots for adults
Were members ages 18 to 64 vaccinated against the flu?
1.0
 
Add Treatment
3.0
  
Asthma
2.0
Asthma control
Did people, ages 5 to 64, with persistent asthma have an appropriate ratio of asthma medications to help control their symptoms?
1.0
Asthma drug management
Did people, ages 5 to 64, with persistent asthma take medications to control their asthma as prescribed?
3.0
Diabetes
2.5
Blood pressure control (140/90)
Did diabetic members ages 18 to 75 have their blood pressure below 140/90 at their last visit?
3.0
Eye exams
Did diabetic members ages 18 to 75 have a retinal or dilated eye exam?
2.0
Glucose control
Did diabetic members ages 18 to 75 maintain their blood sugar level below 8 percent?
3.0
Patients with diabetes – received statin therapy
Did members ages 40 to 75 with diabetes who do not have cardiovascular disease receive a statin medication?
1.0
Patients with diabetes – statin adherence 80%
Did members ages 40 to 75 with diabetes who do not have cardiovascular disease stay on statin therapy as prescribed?
3.0
Heart disease
3.5
Patients with cardiovascular disease – received statin therapy
Did males 21 to 75 and females 40 to 75 with cardiovascular disease receive a high or moderate-intensity statin medication?
3.0
Patients with cardiovascular disease – statin adherence 80%
Did males 21 to 75 and females 40 to 75 with cardiovascular disease stay on high or moderate-intensity statin therapy as prescribed?
5.0
Controlling high blood pressure
Did hypertensive patients ages 18 to 85 have their blood pressure controlled (i.e., for patients 18 to 59 a BP <140/90 mm Hg, for patients 60 to 85 with a diagnosis of diabetes a BP <140/90 mm Hg or a BP <150/90 mm Hg without a diagnosis of diabetes)?
3.0
Mental and behavioral health
2.5
Continued follow-up after ADHD diagnosis
Did children ages 6 to 12 who were on ADHD medication for at least 210 days have at least two follow-up visits within 9 months?
NA
Depression: Adhering to medication for 6 months
Did adult members with a new episode of depression take a prescribed antidepressant drug for at least 6 months?
2.0
Follow-up after hospitalization for mental illness
Were members hospitalized with a mental illness aged six and older followed up within a week after discharge?
4.0
Follow-up after ED for mental illness
Were members ages six and older with an ED visit for mental illness followed up within a week of their visit?
3.0
Follow-up after ED for alcohol and other drug abuse or dependence
Were members ages 13 and older with an ED visits for alcohol or other drug abuse or dependence followed up within a week of their visit?
2.0
Alcohol or drug abuse or dependence treatment engaged
Did alcohol- or drug-dependent members 13 and older receive two or more inpatient or outpatient care services within 34 days?
2.0
Cholesterol and blood sugar testing for youth on antipsychotic medications
Did members ages 1 to 17 who were on two or more antipsychotic medications have their blood sugar and cholesterol tested?
NA
First-line psychosocial care for youth on antipsychotic medications
Did members ages 1 to 17 who had a new prescription for an antipsychotic medication have documentation of psychosocial care as first-line treatment?
NA
Other treatment measures
Acute hospital utilization
For members ages 18 and older, how many unplanned acute inpatient and observation stays occurred during the year?
3.0
Observed-to-expected hospital readmissions
For members ages 18-64, how many hospital stays were followed by an unplanned hospital readmission within 30 days after discharge?
3.0
Emergency department utilization
For members ages 18 and older, how many emergency department visits were unplanned during the year?
5.0
Appropriate antibiotic use, adults with acute bronchitis
Were adults ages 18 to 64 with acute bronchitis not prescribed antibiotics in the 3 days after their diagnosis, as recommended?
3.0
Appropriate testing and care, children with sore throat
Were children ages 3 to 18 with a sore throat given strep tests and appropriately prescribed antibiotics?
2.0
Appropriate use of imaging studies for low back pain
Were imaging tests appropriately not recommended for patients with a new episode of low back pain?
5.0
Avoiding opioids at high dosage*
Were members ages 18 and older not prescribed opioids at a high dosage for 15 or more days?
3.0
Avoiding opioids from multiple prescribers and multiple pharmacies*
Were members ages 18 and older who received prescription opioids for 15 or more days not prescribed opioids from four or more different prescribers and four or more different pharmacies?
3.0
Steroid after hospitalization for acute COPD
Did members 40 and older who were hospitalized or had an ED visit for chronic obstructive pulmonary disease receive systemic corticosteroids within 14 days of discharge?
NA
Bronchodilator after hospitalization for acute COPD
Did members 40 and older who were hospitalized or had an ED visit for chronic obstructive pulmonary disease receive a bronchodilator within 30 days of their discharge?
NA
Appropriate antibiotic use, children with colds
Were children ages 3 months to 18 years with colds not prescribed antibiotics up to three days after their diagnosis, as recommended?
3.0