Financial Metrics
The bottom portion of each bar is the total number of medical and behavioral health claims paid each month by the health plan.
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.
Outcome Metrics
Tdap (tetanus, 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.
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.
Higher percentages of children in this measurement generally means members are using the services available to them, which leads to better child health outcomes.