Local Health Care Providers Propel CenCal Health to top 5% Nationwide in Postpartum Care
Two industry audits substantiate high quality of pediatric care provided by Medi-Cal physicians on Central Coast
SANTA BARBARA, Calif. – Oct. 6, 2022 – CenCal Health, the community health plan for Medi-Cal in Santa Barbara and San Luis Obispo counties, received high marks in two respected professional health care assessments– the national Healthcare Effectiveness Data and Information Set (HEDIS®), and the state-wide report on Consumer Assessment of Healthcare Providers and Systems (CAHPS®). With results released in 2022, the findings in both annual audits concluded that, in multiple categories, CenCal Health and its providers delivered exceptional care to child members, as well as members that are new mothers and members with diabetes.
According to the HEDIS results for pediatric members of the nation’s Medicaid plans, San Luis Obispo County rated in the top 5% for weight assessment, physical activity counseling, and nutrition counseling for children and adolescents. Santa Barbara County rated in the top 10% nationally for meningococcal, Tdap and human papillomavirus (HPV) immunizations for adolescent plan members, ages 9-13.
In addition, for the second year in a row, both counties covered by CenCal Health received the highest HEDIS rating – top 5% in the nation – for timeliness of women’s postpartum care. This year, the community health plan also rated in the top 10% nationally for having a low rate of diabetic members with HbA1c poor control. This means that a higher percentage of CenCal Health members with diabetes had better blood glucose control compared to Medicaid members with diabetes in other plans nationwide.
CenCal Health’s HEDIS measurements are independently audited and reported annually to the National Committee for Quality Assurance (NCQA) to demonstrate the quality of care rendered by CenCal Health’s providers.
“CenCal Health prides itself on partnering with committed and compassionate physicians, clinics, hospitals and health care specialists in both counties,” said CenCal Health CEO Marina Owen. “It is because of these outstanding provider partners – with support from CenCal Health – that our organization and community have achieved these excellent results in both evaluations.”
CAHPS is the health care survey on patient experience that asks consumers and patients to report on and evaluate their experiences with health plans, providers and healthcare facilities. With funding from the California Department of Health Care Services (DHCS), the Health Services Advisory Group (HSAG) is the designated External Quality Review Organization that administered the current CAHPS survey. DHCS and CenCal Health use CAHPS results to improve patients’ experiences with care.
In 2021, HSAG surveyed consumers in 25 health plans in California, ranking CenCal Health No. 1 in Customer Service for Child Members, No. 2 in Overall Rating of Health Plan for Child Members, and No. 3 in Overall Rating of Personal Doctor for Child Members.
“During the pandemic, we saw diminished preventative care-seeking behaviors in our local population,” said Dr. Tamara Battle of Central Coast Pediatrics. “Recovery has been an important part of supporting the health and well-being of our patients. Central Coast Pediatrics strives to assist families in achieving health outcomes that enrich the lives of children in our community.”
The measurement period for the latest HEDIS report ended December 31, 2021. For CAHPS, the survey was available to consumers from February to May 2021, with ratings representing members’ experiences of care and service over the prior six months.
HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).
HEDIS is a set of standardized performance measures designed to ensure that purchasers and consumers have the information they need to reliably compare health care quality. The NCQA accredits and certifies a wide range of health care organizations and manages the evolution of HEDIS, the performance measurement tool used by more than 90 percent of the nation’s health plans.
Developed by The Agency for Healthcare Research and Quality (AHRQ), the Consumer Assessment of Healthcare Providers and Systems (CAHPS) is a standardized HEDIS survey instrument to assess the patient experience of health plan members. The survey prompts consumers and patients to report on and evaluate their experiences with health plans and providers. The survey results are used to improve patients’ experiences with care. CAHPS is a registered trademark of the Agency for Healthcare Research and Quality.
About CenCal Health
CenCal Health is a community-accountable health plan that partners with over 1,500 local physicians, hospitals and other providers in delivering patient care to nearly 220,000 members – about one in four residents of Santa Barbara County and one in five residents of San Luis Obispo County. A public agency, the health plan contributes approximately $50 million a month into the local economy, primarily through payments to healthcare providers who serve its membership. Established in 1983, it is the oldest Medicaid managed care plan of its kind in the nation. View its annual Community Report at cencal2021.org.
CenCal Health Contact:
Nicolette Worley Marselian
(805) 685-9525 ext.1993