Bear Facts. The results are in! The. Take a look and see how Healthcare USA stacks up. A HealthCare USA Member Newsletter Volume

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1 The Bear Facts A Member Newsletter Volume The results are in! Take a look and see how Healthcare USA stacks up. 100% 95% 90% 85% 80% Rating of Health Plan Overall Rating of Health Care Overall Customer Service Getting Needed Care Getting Care Quickly Look inside for complete survey results...

2 CAHPS MEMBER SATISFACTION SURVEY RESULTS CAHPS (Consumer Assessment of Healthcare Providers and Systems) is a satisfaction survey sent to random members. It asks you what you think about your child's healthcare,, and your healthcare providers. This table below shows our results from 2014 compared to those in The Green Rows show where you ranked us higher in 2014! Thank You!! Topic HealthCare USA 2013 Results 2014 HealthCare USA 2013 NCQA Quality Compass Medicaid Rating of Health Plan Overall 84.14% 87.43% 82.89% Rating of Health Care Overall 87.45% 88.00% 83.00% Rating of Personal Doctor Overall 86.34% 88.67% 87.04% Rating of Specialist Overall 82.14% 85.20% 84.36% Customer Service 91.21% 91.91% 87.31% Getting Needed Care 86.72% 89.84% 84.20% Getting Care Quickly 93.40% 94.65% 89.07% How Well Doctors Communicate 94.09% 94.81% 92.52% Coordination of Care 80.00% 84.75% 80.06% Ability to Find a Doctor who met cultural/language needs Health Care staff was sensitive to your cultural needs Received Health Care services in a language you could understand 86.50% 87.27% 90.20% 91.88% 87.12% 86.30% Not Reported ly Not Reported ly Not Reported ly Overall Rating of Dental Care 85.65% 86.34% Not Reported ly If you receive a survey next spring, please take the time and let us know what you think about the care and services that your child is receiving. Your input makes us better.

3 2014 HEALTHCARE EFFECTIVENESS DATA &INFORMATION SET RESULTS (HEDIS ) At, our goal is to help you get the care you need to improve your health. That s why we remind you about care you should get. How well are we doing? This chart shows our HEDIS results from 2013 to It also shows the average HEDIS results for Medicaid in the U.S. overall for (The higher the number, the better the results.) Thank you for seeking care and: Visiting the dentist Getting breast cancer screenings Getting immunizations and lead screenings Seeing the doctor more during each pregnancy Taking asthma medication correctly Testing blood sugar levels regularly if needed Topic HealthCare USA 2013 Results 2014 HealthCare USA 2013 NCQA Quality Compass Medicaid Adolescent Well Care Visits 51.62% 44.19% 49.69% Annual Dental Visit - ages 2-21 years old 47.19% 50.67% 49.17% Breast Cancer Screening 42.98% 46.85% 51.82% Cervical Cancer Screening 71.59% 65.25% 64.51% Childhood Immunizations with Lead Screening by 2nd Birthday Combination % 72.22% 75.74% Chlamydia Screening - all Women 61.55% 57.66% 57.1% Diabetes - Eye Exam 50.12% 48.95% 53.17% Diabetes-HBA1C Testing (Blood Sugar Level Testing) Frequency of Prenatal Care, 80% or more of recommended visits Postpartum Care (Mom's visits after baby is born) Prenatal Care (visits before baby is born) Asthma - Appropriate use of Medications - all ages Well Child Visits 0-15 months, 6 or more visits 57.76% 72.03% 82.98% 64.55% 65.55% 60.45% 68.54% 69.86% 63.05% 92.96% 91.63% 82.93% 85.7% 88.75% 83.88% 62.89% 62.53% 63.65% Well Child Visits 3-6 years old 74.59% 67.51% 72.0%

4 Monitoring your DIABETES Regular checkups with your diabetes healthcare provider are very important. Checkups let you know how you are doing with your diabetes and if any changes to your care need to be made. There are several indicators used to measure your diabetes. In this article we will discuss the importance of your Hemoglobin A1C number. Hemoglobin A1c is a measurement of diabetes control over the past 2-3 months. Understanding your A1C numbers - Talk with your diabetes healthcare provider about your personal A1C goal. Then you can work with your healthcare provider to find ways of meeting this goal. By lowering you A1C even 1 percentage point, you can reduce the risk for eye, kidney, nerve and heart problems. Less than 7% - your diabetes treatment plan is currently working. Good job! Your blood glucose is fairly well controlled. This helps cut down the risk of health problems because of your diabetes. Over time, changes in your treatment plan may be needed. Greater than 7% - your levels should be a priority. Work with your diabetes healthcare provider to reduce your level. Each percentage point over 7 greatly increases your risk by developing diabetes related complications, such as eye, kidney, nerve and heart problems. In future articles we will discuss the importance of routine eye exams, nephropathy care, and maintaining a healthy blood pressure. Source: American Diabetes Association WANT TO KNOW MORE ABOUT A Health Topic? If you want to learn more about almost any health related topic, we can help! 1. Just go to our website at 2. Click on the Member section 3. Then Click on the KidsHealth logo on the right Once you are there you can learn about most any health topic. You can explore easy to understand: Articles Videos Interactive games Homework help And, much more The content is divided into areas for kids, teens & parents.

5 PLEASE provide YOUR CURRENT INFORMATION It is very important that has your current address and phone number. We want to make sure you get all of your mail from and MO HealthNet. To update your address and phone number just call FSD-INFO ( ) or visit their website at to access the FSD Program Enrollment System online. You may lose your coverage if you are not able to get important mail about your eligibility. BENEFITS DID YOU KNOW? All members have behavioral health benefits. You can talk with a counselor or a therapist. Need help finding a provider? Simply call Member Services at SEARCH OUR ONLINE PROVIDER DIRECTORY You can search our entire list of healthcare providers on our website. Simply go to and click on Locate a Provider at the top of any page. Then, create your own list of providers. If you need help finding a provider, contact Member Services at

6 HealthCare Care USA Management Services offers care management services to members with health problems. Some of these health problems include: Anxiety disorders, depression or other behavioral health issues Cancer Asthma Cardiac Disease Chronic pain Depression Hepatitis C Children with high lead levels High-risk newborns High-risk pregnancy HIV/AIDS utilization management Our Utilization Management (UM) program has guidelines that help make sure you get the right services in the right place. s Utilization Management staff is available Monday Friday. You may call Member Services 8am to 5pm to ask questions about our Utilization Management program. Member Services may transfer your call to the Utilization Management Department for a staff member to help you. After business hours, callers get a recorded message. There are directions on how to reach someone, immediately. You may also leave a message. We will call you the next business day. If you need TTY/TDD services, you can reach us by calling or 711. If you need language help when discussing UM issues just ask Member Services at Multiple Admissions Pervasive Developmental Disorder Special health care needs, including autism spectrum disorder You, your caregiver or your PCP or other practitioner may ask for care management services at any time. Call us at (800) to learn about care management. MEMBER RIGHTS & RESPONSIBILITIES As a member, you have certain rights and duties. You can get a complete copy of your Rights and Responsibilities at any time. Here s how: Call Member Services at Go to Look in your Member Handbook

7 Providing You QUALITY SERVICE IS OUR TOP PRIORITY has been providing quality service to members for almost 20 years. As the largest managed care health plans in Missouri, we partner with many health care providers and other community organizations to give you complete and high quality care Monday Friday, 8a.m. 5p.m. We will listen to your concern. We will look into your concern and let you know what we learn. has earned the Commission for Quality Assurance (NCQA) Commendable Accreditation for health plans. This means that adheres to high standards that have been established for health plans to achieve quality outcomes. If you are not happy with the quality of care you received, you may file a grievance by calling Member Services at IMPORTANT TOLL-FREE NUMBERS HEALTHCARE USA Member Services Transportation Transportation Fax Behavioral Health Hour Nurse Line CMPCN 24-Hour Nurse Line (Children's Mercy Pediatric CARE Network) Family Support Division (FSD) Information Center Child Abuse/Neglect Missouri Hotline Hour Parent Support Line Missouri School Violence Hotline Poison Control Center Child Support General Information Food Stamp Hunger Line MO HealthNet Participant Services Smoking Cessation 800-QUITNOW TTY/TDD 711 or

8 10 South Broadway, Ste St. Louis, MO IN THIS ISSUE... MONiTORiNG YOUR DiAbeTeS MeMbeR RiGHTS AND ReSpONSibiliTieS ANNUAl CAHpS AND HeDiS ReSUlTS hcusa.org MAKE MY VISIT BETTER Being prepared when you see your health care provider is important. Asking questions is your right and a good idea. Knowing what questions you want to ask ahead of time helps. Use this guide whenever you or a family member has a health care visit. You will be glad you did! This visit is for me Provider Name This visit is for my child Questions I Need to Ask Appointment Date / / Appointment Time : AM PM Reason(s) For Visit Instructions I was given Medications I Take (Don t forget to list medicines that do not need a prescription too) Does the provider want to see me again? When? Follow-Up Appointment? Date / / Time : AM PM Still need help knowing what questions to ask? Call our 24 Hour Nurse Help Line! We can help by listening and then give you ideas on what you should ask at your appointment. Our number is on the back of your member ID card. To receive a translated copy of this document, call Member Services at Para recibir una copia traducida de este documento, llame al servicio para miembros al HCU /03/14