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Quality matters

Staying focused on providing the best for our members

We are committed to providing you with a superior level of care and service. Our goal is to ensure the right care, at the right place, at the right time and with the right provider. And we're thrilled to be recognized for our quality efforts.

Prevea360 Health Plan commercial HMO plans are accredited by NCQA
Accreditation status is one of the most important indicators of how a health plan stacks up for quality. The National Committee for Quality Assurance (NCQA) – an independent, not-for-profit organization – evaluates health plans based on more than 50 care and service standards.

You're in the right place for quality

We’re working hard every day to provide the highest-quality coverage possible. It’s the kind of peace of mind that comes with being a Prevea360 Health Plan member.

Member Satisfaction/Quality of care. We measure our member satisfaction through a nationally-standardized member satisfaction survey, known as CAHPS. And we monitor our quality of care through a nationally standardized set of measures: Healthcare Effectiveness and Data Information Set (HEDIS).
Patient Safety. Patient Safety is one of the most important aspects of health care. Prevea360 Health Plan is committed to providing you with information that enables you to take an active role in obtaining the safest care possible.
Quality Improvement Program. We are committed to improving the health and health care of our members. We provide educational materials and resources to help members make informed decisions regarding their health.
HIPAA Transactions. Prevea360 Health Plan supports all HIPAA-compliant electronic transactions.
Fraud. Together, we can work to help control the cost of health care.

Prevea360 Health Plan is constantly monitoring our quality performance through national and regional standards as determined by the National Committee for Quality Assurance (NCQA).

NCQA is an independent, not-for-profit organization dedicated to measuring the quality and awarding levels of accreditation based on the results of the Healthcare Effectiveness Data and Information Set (HEDIS® is a registered trademark of the National Committee for Quality Assurance. NCQA HEDIS Compliance Audit® is a registered trademark of NCQA) and the Consumer Assessment of Healthcare Providers and Systems (CAHPS®).

These standards are purposely set high to encourage health plans to continuously improve the quality of care and customer service.

Medicare evaluates plans based on a five-star rating system. Star Ratings are calculated each year and may change from one year to the next.

Plan quality ratings and enrollee survey results are calculated by CMS using data provided by health plans in 2023 for the 2024 plan year. The ratings are being displayed for health plans for the 2024 plan year. Learn more about these ratings