Newsroom > DHHS News Release

FOR IMMEDIATE RELEASE
January 30, 2018

CONTACT
Julie Naughton, Public Information Officer, Communications and Legislative Services, (office) 402-471-1695 or (cell) 402-405-7202, julie.naughton@nebraska.gov  

Medicaid Heritage Health Reports Positive November, December Data

Lincoln – Heritage Health, Nebraska Medicaid’s managed care delivery system, continues successfully serving more than 230,000 of Nebraska’s most vulnerable citizens, according to Thomas “Rocky” Thompson, interim director of the Division of Medicaid and Long-Term Care in the Department of Health and Human Services.

Heritage Health performance results are public and can be found in the Heritage Health dashboard report at http://dhhs.ne.gov/medicaid/Pages/HeritageHealthPlans.aspx. It includes information about enrollment, claims and claim timeliness, grievances and appeals, and response times. Thompson shared the most recent monthly data with state senators today. The following provides highlights: 

Claims
  • Paid claims:  
 Nebraska Total Care ​ UnitedHealthcare​ WellCare​
​November 2017  ​139,450  ​100,329  ​93,756
December 2017 ​ ​117,503  ​96,874  ​85,093

 

  • Paid pharmacy claims:
 Nebraska Total Care ​ UnitedHealthcare​ WellCare​
​November 2017  127,369  ​93,236  ​49,021
December 2017 ​ ​143,168  ​103,225 52,513
 
  • All three plans maintain known issue logs on their websites which include the resolution dates or expected resolution dates for all identified issues. Links to the issue logs for each Managed Care Organization can be found in the footnotes123.
Enrollment
  • Enrollment in each of the managed care organizations’ plans remained stable, with Nebraska Total Care at 76,604, UnitedHealthcare at 79,036, and WellCare at 74,786.
  • 13,433 Heritage Health recipients are enrolled in Case Management to actively manage potentially high-expense conditions.
  • Open enrollment for the 2018 Heritage Health plan year began on November 1st and concluded on December 15th.
  • A comparison of the plans, including a list of value-added services, is available online4.
Provider Calls
  • Call abandonment for providers:
 Nebraska Total Care ​ UnitedHealthcare​ WellCare​
​November 2017  .9% 1% ​2.2%
December 2017 ​ .6% ​.5% .8%
 
  • Average call length for providers in:
 Nebraska Total Care ​ UnitedHealthcare​ WellCare​
​November 2017  10.7 min.  8.3 min. 10.8 min.
December 2017 ​ 9.8 min. 8.3 min. 10.2 min.
 
  • Call abandonment for members:
 Nebraska Total Care ​ UnitedHealthcare​ WellCare​
​November 2017  .6%  1% 1.8%
December 2017 ​ .4%  .4% .7%
 
  • Average answer speed for members: 
 Nebraska Total Care ​ UnitedHealthcare​ WellCare​
​November 2017  5 sec. 17 sec. 14 sec.
December 2017 ​ 5 sec. 8 sec. 9 sec.

 

  • Average call length for members: 
 Nebraska Total Care ​ UnitedHealthcare​ WellCare​
​November 2017  7.8 min. 9.8 min. 7.9 min.
December 2017 ​ 8.1 min. 10.1 min.  7.9 min.

 

  • Average hold time for members:
 Nebraska Total Care ​ UnitedHealthcare​ WellCare​
​November 2017  23 sec. 98 sec. 14 sec.
December 2017 ​ 21 sec. 97 sec.  9 sec.
   
 
Heritage Health continues to make a measurable difference in members’ lives. One of Nebraska Total Care’s Developmental Disabilities Care Managers has been working with an adolescent who was diagnosed as a toddler with a complex genetic disorder.  Due to the condition, she has delayed development, intellectual disability, speech impairment, severe seizures, and significant problems with movement and balance.
 
The member uses alternative communication modes and primarily uses a wheelchair. Her mother’s priorities are clear: to control her seizures and to control her weight. This member has taken advantage of NTC’s value added benefit of YMCA membership. Recently, her mother reported that although her weight fluctuates, she has gained balance and stability, which she did not have before participating in the YMCA water aerobics program. She can now walk on a treadmill for 5 minutes. Perhaps the most important improvement noted by the member is her ability to walk with crutches between her classes at school. Her mother reports that this alone has done more for her daughter’s social acceptance by her peers than anything else. 

-30-

 

1 Nebraska Total Care issue log, http://bit.ly/2n7RSiu
2 WellCare issue log, http://bit.ly/2rDK5hR
3 United Health Care Community Plan issue log, http://bit.ly/2F97rxG
4 MCO plan comparison, http://bit.ly/2ncI5bd