The following graphics detail Heritage Health’s performance, including membership, finances, customer service, outreach, and health outcomes, since the program’s launch in January 2017.
The following abbreviations are used for each of the health plans in the Heritage Health program:
• NTC- Nebraska Total Care
• UHC- UnitedHealthcare Community Plan of Nebraska
• WHP- WellCare of Nebraska
For data in an accessible format, see the link below.
August 2018’s enrollment was 231,185 members. That month, Nebraska Total Care covered 33.3 percent of enrollees, UnitedHealthcare Community Plan covered 33.6 percent, and WellCare of Nebraska covered 33.1 percent.
The bottom portion of each bar is the total number of medical and behavioral health claims paid each month by the health plan. Combined, the three Heritage Health plans paid out over 3.5 million health claims and over 4 million pharmacy claims in 2017.
The bottom portion of each bar is the total quarterly medical expenses paid by each health plan. Medical expenses include all claims paid to providers and pharmacies. Administrative expenses include all expenses that don’t directly go toward providing health care for Heritage Health members, such as operational expenses.
Customer Service Metrics
All state agencies share a focus on customer service. The following four charts detail the quality of over-the-phone service Heritage Health members and health care providers receive.
Starting in 2018, MLTC required all three plans to report this measure in the same way. This year, all plans start tracking their calls from the moment the member calls into the company.
Engagement and outreach between the health plans, members, and providers is an essential part of making Heritage Health a success. The following charts provide counts of various provider and member engagement events by each health plan throughout the state. These events include provider orientation sessions, community baby showers, and health fairs.
Monthly counts include the number of separate member outreach events.
Monthly counts include the number of new provider orientations, provider visits, and provider webinars conducted by each plan.
Diphtheria, and Pertussis) vaccinations are one of the key performance
improvement projects Heritage Health monitors. According to the CDC, the
vaccine is most beneficial to the health of the newborn if the vaccine is
administered between weeks 27 and 36 of the pregnancy.
The left bar in
each pairing refers to pregnant mothers who received the vaccine at any time in
their pregnancy. Heritage Health’s long-term goal for this figure is for all
plans to reach Target A, at 75 percent.
The right bar in
each pairing refers to pregnant mothers who received the vaccine between weeks
27 and 36 of their pregnancy. Heritage Health’s long-term goal for this figure
is for all plans to reach Target B, at 63 percent.
measurement requires the Heritage Health member to be continuously enrolled in
the same plan from week 26 of the pregnancy until delivery, the earliest data
available is from Q3 2017. These figures are estimates and subject to change as
new information becomes available.
Monitoring this figure is one way Heritage Health promotes
the health of its youngest members.
This measurement is the percentage of
members who turned 15 months old during the measurement quarter who were
continuously enrolled in one health plan and had six or more well-child visits
with a primary care provider during their first 15 months of life. The red line
represents Heritage Health’s goal for this measurement: 52 percent.
To allow for continuous enrollment in
one health plan, data for this measure begins 15 months after the first quarter
Heritage Health began: Quarter 2, 2018.
Higher percentages of children in
this measurement generally means members are using the services available
to them, which leads to better child health outcomes.
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