United Healthcare Community Plan wants you to get the best care and service. That’s why we have a Quality Management (QM) program. Our QM program helps us learn what we can do better. Then we use it to improve. Our QM program has several member health programs.
Help people with health conditions like asthma, diabetes, heart disease, depression, bipolar disorder and schizophrenia
Help pregnant women have healthy babies
Help people stay healthy with shots, screenings, and tests
Improve patient safety
Make sure members are happy with the plan
Make sure doctors and other health care professionals meet our standards
We use national standards to see how well our QM program works. The National Committee for Quality Assurance (NCQA) writes the standards. NCQA is an independent agency. It compares the quality programs of health plans. We measure our progress meeting our goals using NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) Consumer Assessment of Healthcare Providers & Systems (CAHPS®). HEDIS® and CAHPS® results are given in a national report card. Below you will find our 2020 TennCare HEDIS® and CAHPS® highlights. The box compares our results to national averages:
ÇPopulation-eligible members were 17 years and younger, as of 12/31/2019.
*Percentage reflects members who rated their plan/provider 9 or 10 on a scale of 0-10, 10 being best.
N/A assigned when number of respondents total less than 100.
#Percentage reflects respondents indicating ‘always’ or ‘usually’.
**National Average is based on the HEDIS® 2020 NCQA 50th percentile.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).
Learn more. If you would like to know more about our quality health programs, visit uhccommunityplan.com. A paper copy of our QM Program Description is available upon request. Please call Customer Services at 1-800-690-1606 for a copy.