Healthline member newsletter

CHP's Commercial Plan Ranked 4th in the Nation

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Capital Health Plan (CHP) has once again received national acknowledgement. It is ranked 4th in the nation for commercial health plans according to “NCQA’s Health Insurance Plan Rankings 2010-2011 – Private” published by the National Committee for Quality Assurance (NCQA). This ranking makes CHP the top-ranked plan in Florida. CHP’s commercial plan was ranked 5th in the nation in the 2009-10 “America’s Best Health Insurance Plans” by NCQA and U.S. News & World Report.

NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations.

“We are honored Capital Health Plan continues to receive recognition from NCQA which is only possible with the support of our members and our community.” said John Hogan, CEO of Capital Health Plan. “This distinction reflects the outstanding work of our doctors, nurses and administrators. “

The NCQA Health Insurance Plan Rankings 2010-11 - Private are based on clinical performance, member satisfaction and accreditation information.

“We are proud of this exceptional ranking, and we especially applaud our committed physicians and clinical staff for their commitment to the well being of our members and the community,” said Dr. Nancy Van Vessem, Chief Medical Officer of Capital Health Plan. “Over several years, we have worked together to offer CHP members evidence-based care for diabetes, heart disease and other conditions. Our shared goal is to strive to reduce catastrophic complications such as stroke and heart attack for our patients. We will continue seeking ways to improve the quality of the health care services we deliver.”

As part of its commitment to excellence, Capital Health Plan continues to focus on three primary strategic initiatives:

  • Improving the health of the population
  • Enhancing the patient experience of care (including quality, access, and reliability)
  • Controlling trends in the per capita cost of care

John Hogan reflects, “We have a lot to accomplish in all three areas, as does our nation, but the capital region definitely stands out in these efforts.”

The Service Area is Expanding!

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Beginning in 2011, Capital Health Plan will serve Calhoun and Liberty counties. Members renewing effective January 1, 2011 will be eligible if they live or work in Leon, Calhoun, Gadsden, Jefferson, Liberty, or Wakulla counties. Medicare members will be eligible to enroll in a Capital Health Plan Medicare Advantage plan if they live within the expanded service area.

 

We look forward to providing even more members with quality, affordable care.

CHP Performs Well in NCQA’s Quality Compass® 2010

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Quality Compass® is NCQA’s comprehensive national database of health plans’ HEDIS® and CAHPS® results. NCQA uses this data along with NCQA Accreditation standards to calculate plan rankings. These scores reflect the results of consumer surveys and success in prevention and treatment compared to other plans.

Capital Health Plan received the following ratings of distinction for its commercial plan:

  • CHP has the highest score in the nation for Colon Cancer Screening (3 of the last 4 years)
  • CHP ranks in the 90th percentile nationally for diabetes care, cervical cancer screening, follow-up after hospitalization for behavioral health problems, cholesterol screening for people with vascular disease, breast cancer screening, appropriate medication use in asthma and multiple other measures.
  • Members also scored Capital Health Plan in the 90th percentile nationally for overall plan rating and satisfaction with customer service.

Capital Health Plan’s commitment to member satisfaction shows in the outstanding member ratings for customer service and overall satisfaction with the plan. Tools like CHPConnect and CHP Health Coaching help members take control of their health. And, Capital Health Plan’s local member services department strives to deliver efficient, expert service.

John Hogan, CEO of Capital Health Plan, notes, “This feedback only furthers CHP’s dedication to delivering high quality, affordable health care and service to our community.”

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

Where Your CHP Dollar Goes

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Capital Health Plan tries to keep coverage affordable and focused on hospital, physician, drug and other health care services. Through the first seven months of 2010, administrative costs represent less than 4% of our total revenues, one of the lowest levels in the nation. CHP overhead has been below 5% of revenues for the past 20 years. This means that more of your dollar goes directly toward providing the health care services you need.

Advantage Primetime: The Savvy Senior

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Capital Health Plan presents Savvy Senior programs each month for older adults who want to learn more about how to live healthy, happy and active lifestyles.

We repeat the programs each month in Leon, Gadsden, Wakulla, and Jefferson counties. The events are free and open to anyone. Call 850-523-7333 to RSVP or to find out about dates and times for programs in Gadsden, Wakulla, or Jefferson County.

If you are unable to attend in person, check out the podcast of these events on our website, capitalhealth.com/Members/Live-Healthy/Savvy-Senior-Podcast.

Below are upcoming Savvy Senior programs held at Capital Health Plan’s Governor’s Square Health Center, 1491 Governor’s Square Blvd., Tallahassee.

Friday, October 1, 2010

  • Noon to 1 p.m.
  • Preventing Falls
  • Mary Goble, R.N.

Friday, November 5, 2010

  • Noon to 1 p.m.
  • Medicare Advantage Update
  • Melissa Dancer-Brown

Friday, December 3, 2010

  • Noon to 1 p.m.
  • Five Wishes
  • Mary Goble, R.N.

Listen to what seniors are saying about The Savvy Senior:

“Outstanding program for general public!”
“Excellent - I always come away with some new information.”
“Very helpful and informative”
“I give you five stars for this program. You said it like it is.”
“As always, I am pleased to report that your programs are superb.” “The Savvy Senior program is an excellent educational tool.”
“The information was very helpful and understandable.”

Flu Season: What You Need to Know

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Are you ready for flu season? Yearly epidemics of seasonal influenza occur typically during the late fall through early spring. The best way to prevent the flu is by getting vaccinated each year. Vaccination is recommended for anyone over six months who wishes to reduce the likelihood of becoming ill with influenza or of transmitting the virus to others should they become infected.

The flu is unpredictable, but the 2009 H1N1 viruses as well as the regular seasonal viruses will likely cause illness in the U.S. this flu season. The 2010-11 flu vaccine will protect against three different flu viruses: an H3N2 virus, an influenza B virus and the H1N1 virus that caused so much illness last season. The 2010-11 flu vaccine is now available, and Capital Health Plan members have multiple ways to receive it. Members may receive vaccination at their primary care physician’s office.

The vaccine is also available at the Leon County or Wakulla County Health Departments. Beginning October 1, CHP members may also get the vaccine at one of the following pharmacies: CVS, K-Mart, Publix and Winn-Dixie.

Facing a health care decision? We can help.

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Imagine being diagnosed with a medical condition for which there is more than one treatment choice. How do you weigh the pros and cons of each treatment? How do you choose among the different options if one treatment is not obviously better than the others?

If this sounds complicated, don’t worry. At Capital Health Plan, we believe patients make the best medical decisions when they are most knowledgeable about the options that are available. We believe Shared Decision-Making can help you make the best decisions for your health.

Shared Decision-Making means that you and your Primary Care Provider (PCP) work together to choose a treatment that is right for you. Often times, specialists recommend surgery or other treatment options. While the specialist has your best interest at heart, your PCP knows you and your medical history best. Your PCP will be better able to assess your risks for a particular treatment option.

Capital Health Plan provides tools to assist you with Shared Decision-Making:

Informational DVDs/videos available on CHPConnect. These video programs contain unbiased information on more than 20 different topics including: having a hysterectomy to treat abnormal uterine bleeding, treatment options for back pain, and treatment options for prostate cancer. The videos are evidenced based and free of commercial bias. They are developed by the Foundation for Informed Decision-Making and are reviewed on a periodic basis ensuring that the content reflects current best practice. The best news is that you can access the video programs 24/7 from your computer by logging onto CHPConnect at capitalhealth.com.

Telephone access to Health Coaches 24 hours a day, 7 days a week. Health Coaches are specially trained health care professionals, such as nurses, dietitians, and respiratory therapists. They can help you understand your health condition, provide reliable information about treatment options, support you in preparing for a discussion with your doctor, and help you think through your decision. CHP Health Coaches can be reached at (850) 383-3400. There is no out of pocket expense to members to access this service.

Interactive online tools through CHP Health Coaching. Log on by visiting capitalhealth.com and clicking on the Member Login (CHP Health Coaching) link. Members have access to:

  • Healthwise: an online encyclopedia of medical information (under the Health Information tab)
  • Health Crossroads Web Modules: decision tools, treatment options and prevention tips (under the Health Information tab)
  • Personal health calculators and symptom diaries (under the Health Tools tab)
  • Personal Health Assessment (PHA): a survey to provide you with a personal health action plan to help you improve your health (under the Health Tools tab)
  • Health modules: modules on stress reduction, back pain, weight loss, smoking cessation, healthy exercise, and others (under the Health Tools tab)

Patients are generally more satisfied with their health care when they participate in making the decisions. We hope that these tools are beneficial to you the next time you are faced with making a treatment decision. If you have questions or difficulties accessing CHPConnect please contact Member Services at 383-3311.

Ask Your Local Member Services Representative

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Capital Health Plan strives to provide our members with outstanding customer service. This section of the HealthLINE answers general coverage or procedural questions that we receive on a regular basis.

Question: My address and/or phone number has changed. How do I update them with CHP?

Answer: It is very important that Capital Health Plan has a correct address and phone number on file for you and your family. During the year we send out several important pieces of literature to explain changes to your benefits, to announce changes to our physician and provider network, or to assist you in optimizing your overall health.

How to correctly update your address:

1) Notify your employer. Notify your employer’s HR office of your change in address. Your employer will forward this information to us to update our records.

2) Notify Capital Health Plan. Mail or fax in a notice to Capital Health Plan’s Enrollment department (fax # 850-523-7369).

The notice must be signed by the subscriber of the policy. You may also notify us through a secure message on CHPConnect. Since CHPConnect includes a secure messaging system, information received through this application allows us to accept and complete your request to change your address. You can register for CHPConnect by visiting capitalhealth.com and clicking on the Member Login (CHPConnect) link.

Address changes cannot be taken over the phone by your Member Services Representatives. However, you may request changes to your phone number by contacting CHP Member Services.

Member Services

Five days a week 8 a.m. – 5 p.m.

850.383.3311 or 800.390.1434

Medicare Member Services:

Seven days a week 8 a.m.– 8 p.m.

850.523.7441 or 877.247.6512

TTY/ TTD: 850.383.3534 or 800.955.8771

Women’s Health & Cancer Rights Act, 1998

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In compliance with this act, mastectomies and related reconstructive surgery are covered benefits for Capital Health Plan members. Coverage includes reconstruction of the surgically altered breast, as well as surgery and reconstruction of the other breast for a symmetrical appearance. Coverage is also available for breast prostheses and for the physical complications of mastectomy, including lymphedemas. If you have any questions, please call Member Services at 850-383-3311.

Step Up for Your Community

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Join Capital Health Plan in supporting charitable walks in our community.

AIDS Walk

  • Sunday, October 16, 2010
  • Tom Brown Park
  • 2:00 p.m. registration
  • 3:00 p.m. walk starts
  • www.bigbendcares.org

2010 Big Bend Start! Heart Walk (Victory Sponsor)

  • Saturday, October 23, 2010
  • Tom Brown Park
  • 9:00 a.m. registration
  • 10:00 a.m. walk starts
  • CHP Fruit Stand
  • www.americanheart.org

Making Strides Against Breast Cancer (Presenting Pink Sponsor)