We strive to improve the quality of our members' health through development of clinical programs and monitoring of improvement activities that focus on acute, chronic and preventive clinical services. These programs include:
Optima Health recognizes the importance of improving the services we provide to our members as well as the clinical care they receive. To continue our record of quality, Optima Health has made a commitment to improve member and practitioner satisfaction and thereby helping to “improve health everyday.”
Member Satisfaction
Annual satisfaction surveys are conducted to measure the satisfaction of our members with the various aspects of the health plan, the care they receive, and their access to physicians. Read more on Member Satisfaction
Physician Satisfaction
Optima Health surveys our network physicians to identify strengths and opportunities for improving the way we work with and service our network of providers.
Complaints and Concerns
Though it may seem strange, we welcome any and all concerns from our members. By tracking and analyzing the complaints we receive, we are able to identify opportunities to improve the service we provide.
HEDIS® and NCQA Accreditation
As part of Optima’s commitment to quality, we participate in an accreditation process administered by the National Committee for Quality Assurance (NCQA). Healthcare Effectiveness Data and Information Set (HEDIS®) are performance measures that are important to the accreditation process. They measure how well Optima is performing in key areas such as: quality of care, access to care and of course member satisfaction. Optima has received the highest accreditation rating of excellent for the past 9 years for our commercial products and 8 years for our Medicaid product.
Mammogram Survey
A mammogram survey was mailed this year to a random sample of 1,000 Optima Health members. Women were asked to list reasons why they might not get a mammogram. The results, in order of priority, were:
- They were too busy.
- It was too painful or they were afraid of the procedure.
- They can’t remember when to schedule it.
- They thought they had a copay.
You should know:
- Breast cancer is more easily treated when caught early.
- There is NO copay for mammograms at Optima Health.
- Breast cancer will not wait for anyone’s schedule.
Don’t delay. Schedule your mammogram today!