GHP is the top ranked plan in Pennsylvania 22 times over according to the Quality Compass® 2010 rankings*.
Below are some of the measures for which GHP is rated tops in Pennsylvania and why they are important to you.
I want a plan that helps me care for my new baby.
- Minimum of six well child visits in the first 15 months
The American Academy of Pediatrics recommends six well-child visits in the first year of life. These visits are important because an infant undergoes substantial changes in abilities, physical growth motor skills, hand-eye coordination and social and emotional growth. Regular check-up are one of the nest ways to detect physical, developmental, behavioral and emotional problems. They also provide an opportunity for the clinician to offer guidance and counseling to the parent.
I want a plan that will actually answer the phone when I call.
This measure reports the percentage of calls received during the measured time frame that were answered within 30 seconds. Customer service is an important dimension of an organization’s ability to provide members with reasonable access to services. Higher performance on this measure should improve member satisfaction.
I want a plan that will give me the right antibiotics when I'm sick.
- Appropriate treatment for an upper respiratory infection (URI)
- Avoidance of antibiotic treatment for acute bronchitis
Antibiotics are most often inappropriately prescribed for adults with an upper respiratory infection and acute bronchitis. Many upper respiratory infections and acute bronchitis cases are viral in nature, meaning that antibiotics would not improve the condition. An estimated 90 percent of acute bronchitis cases have a nonbacterial cause, yet antibiotics are inappropriately prescribed 65 to 80 percent of the time. Inappropriate antibiotic treatment, and misuse and overuse of antibiotics leads to antibiotics drug resistance.
I want a plan that will keep my child healthier.
- Adolescent well child visits for children
- Ensuring children receive the proper immunizations for:
- Mumps-Measles-Rubella
- DTaP (Diphtheria, tetanus and acellular pertussis)
- Oral Polio Vaccine
- Chicken Pox Vaccine
- Pneumococcal Conjugate
- Providing a body mass index (BMI) percentile for children and adolescents
- Providing nutrition counseling for children and adolescents
- Providing physical activity counseling for children and adolescents
By age 2, children should have received several immunizations. These immunizations follow the Centers for Disease Control and Prevention guidelines. Vaccines are a proven way to help a child stay healthy and avoid the potentially harmful effects of childhood diseases.
The weight assessment and counseling for nutrition and physical activity for children and adolescents captures the percentage of members 3-17 years who had an outpatient visit where a BMI was documented and the physician discussed the important of nutrition and exercise. The rapidly increasing prevalence of obesity among children is a major cause for concern. Overweight children are more likely to become obese as adults and develop chronic conditions such as diabetes and heart disease.
I want a health plan that helps me avoid another heart attack.
- Persistent Beta Blocker treatment
This measure examines the use of beta-blockers as a way to prevent a second heart attack. In clinical trials, beta-blockers consistently reduce subsequent coronary events when taken indefinitely. There is evidence to suggest that between 2,900 to 5,000 lives are lost in the Unites States in the first year following a heart attack because beta-blockers are under-prescribed.
I want a plan that helps keep me cancer free.
- Breast cancer screenings
- Cervical cancer screenings
Breast cancer is the second most common type of cancer among American women. This measure looks at the percent of women between 40 and 69 years of age who had at least one mammogram during the past two years. Women whose breast cancer is detected early have more treatment choices and better chances for survival.
Cervical cancer can be detected in its early stages by regular screening using a Pap test. It is recommended that women between 21 and 64 years of age receive a Pap test every one to three years.
We want a plan that helps us keep track of medications.
- Persistent use of angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB). These medications lower blood pressure
- Persistent use of diuretics
Patient safety is important, especially for patients at increased risk of adverse drug events from long-term medication use. Appropriately monitoring a drug therapy allows a physician to assess side effects and adjust dosage accordingly.
I want a plan that helps my employees when they need it.
- Engagement of alcohol and other drug dependence treatment for members 13 and older
- Effective antidepressant medication management during acute phase
- Ambulatory follow up in 7 days for members on antidepressants
- Ambulatory follow up in 30 days for members on antidepressants
There are more deaths, illnesses and disabilities from substance abuse than from any other preventable health condition. This measure looks at the percentage of adults diagnosed with and alcohol or other drug dependence who receive two additional services within 30 days after the initiation of treatment.
In a given year, an estimated 20.9 American adults suffer from a depressive disorder or depression. Without treatment, symptoms associated with these disorders can last for years, or can eventually lead to death by suicide or other causes. Fortunately, many people can improve through treatment with appropriate medications. This measure calculated the percentage of members with major depression who were initiated on an antidepressant drug for a three month acute phase.
It is important to provide regular follow-up therapy to members after they have been hospitalized for mental illness. This ensures that the patient’s transition to the home or work environment is supported and that gains make during hospitalization are not lost. It also helps health care providers detect early post-hospitilization reactions or medication problems and provide continuing care.
I want a plan that helps my child with their asthma.
- Use of appropriate medications for children aged 5-11 with asthma
Asthma is the most common chronic childhood disease, affecting an estimated 5 million children. Successful management of asthma can be achieved, and asthma related suffering, cost and death can be greatly reduced through effective treatment with long-term controller medications.
*The source for data contained in this publication is Quality Compass® 2010 and is used with the permission of the National Committee for Quality Assurance (NCQA). Quality Compass 2010 includes certain CAHPS data. Any data display, analysis, interpretation, or conclusion based on these data is solely that of the authors, and NCQA specifically disclaims responsibility for any such display, analysis, interpretation, or conclusion. Quality Compass is a registered trademark of NCQA. CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).
