Measuring our performance

Learn how we measure our performance. We want to make sure we give you the care and services you need to manage your health.

A nurse visits a patient at home

Ensuring you have the care you need

Learn about the tools we use to measure our performance so we can ensure you have the care you need. Check out how we’re doing in our annual reports.

The tools we use

We use a tool called HEDIS® (Healthcare Effectiveness Data and Information Set) to track the performance of your Kentucky Medicaid plan. Over 90% of America’s health plans use this tool. This large amount of data makes it easier to compare plans. The data is checked by officials using a process created by the National Committee for Quality Assurance (NCQA).

What is measured?

Many important health issues are measured. We measure these areas to make sure we are giving you the care you need.

Some of the areas we measure include:

  • Asthma medication use
  • Continuing use of beta-blocker treatment after a heart attack
  • High blood pressure control
  • Comprehensive diabetes care
  • Breast cancer screening
  • Antidepressant medication management
  • Childhood and adolescent immunization status
  • Childhood and adult weight/body mass index assessment

Helping us improve

These measurements help us see that our Kentucky Medicaid plan is meeting our members’ needs. It also shows us any areas that need improvement and how we can serve you better.

Our quality improvement program helps guide activities to improve care and treatment for our members. For more information about the quality improvement program call 1-800-444-9137 (TTY: 711), Monday – Friday, 7 a.m. – 7 p.m.. Eastern time

Check our scores

You can see for yourself how we score each year. We want you to feel confident that you have made the right choice in your plan.

Members can view the data HEDIS tracks in a yearly report card that shows a complete view of a health plan’s performance. These report cards are often published by national magazines and newspapers.

View the State of Health Care Quality Report, opens new window (NCQA website)

Learn more

If you’re interested in knowing more about how we measure our performance, you can read a more detailed guide. This guide has details on how our HEDIS measurement process works.

Download the guide to HEDIS measurements , opens new window

Looking for help?

Contact us

If you have questions, find the number you need to get help and support.

Find a doctor

Find a doctor, hospital or pharmacy.

Documents & forms

Find the documents and forms you need, including your Enrollee Handbook.