High Quality - Dean Health Plan

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Dean Health Plan is thrilled to be recognized for our never-ending focus
on high-quality coverage for you and your family

As your partner in healthcare, Dean Health Plan is 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.

Quality

Awarded "Excellent Accreditation" Status for Commercial and Marketplace HMO Plans
Accreditation status is one of the most important indicators of how a health plan stacks up for quality. We receive Accreditation by the National Committee for Quality Assurance (NCQA), which is an independent, not-for-profit organization that evaluates health plans based on over 50 standards of care and service to determine health plan Accreditation status. Our “Excellent Accreditation” shows that we deliver exceptional service.

Quality

Rated 4.5 out of 5 Stars for Commercial HMO Plans
NCQA uses star ratings to help consumers easily compare health plans based on quality of care and service. Only seven other Wisconsin health plans received a 4.5 rating for Commercial HMO Plans and no other Wisconsin health plan scored higher in NCQA’s Private Health Insurance Plan Ratings for 2016-2017.

Quality

Rated 4 out of 5 Stars for Individual Marketplace HMO Plans
Ratings by the Centers for Medicare and Medicaid Services (CMS) also help consumers get a snapshot look at a health plan’s quality standing. CMS rated our individual marketplace HMO plan 4 out of 5 stars.

You're in the right place for quality.

We’re working hard each day to provide you the highest-quality coverage possible. It’s the kind of peace-of-mind that comes with being a Dean 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. Dean 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.
  • Utilization Management. Our Utilization Management Program was developed to support our commitment and ensure appropriate utilization of medical resources to maximize the effectiveness of care provided to you.
  • HIPAA Transaction. Dean Health Plan supports all HIPAA-compliant electronic transactions.
  • First-Tier, Downstream and Related Entities (FDRs). Dean Health Plan has contracts with the Centers for Medicare and Medicaid Services (CMS) to administer Medicare benefits to Medicare beneficiaries. Dean may delegate some core health plan functions or health care services to contracted external vendors or providers.
  • Fraud. Together, we can work to help control the cost of health care.

Dean 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®).

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

 

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