Quality and Service

PHP continues to be a top-performing health plan. We consistently rank high in member satisfaction surveys, and we have achieved accreditation from a leading benchmarking program. While we are proud to receive such recognition, we take the greatest satisfaction in knowing that our focus on quality ultimately serves our members. Customer service is our highest priority, and we sincerely welcome feedback on our members’ healthcare experience.

   

Accreditation

URAC, an independent organization that provides benchmarking programs to the healthcare industry, has awarded Physicians Health Plan accreditation status for both its Commercial HMO/POS combined product lines and Marketplace product lines.

URAC evaluates how well a health plan manages all parts of its delivery system – physicians, hospitals, other providers and administrative services –in order to continually improve health care for its members.

During the accreditation process, PHP was measured against rigorous standards in the areas of:  
  • Customer service and addressing member concerns
  • Providing high credentialing standards for providers
  • Responding to member and practitioner issues
  • Listening to and addressing feedback of new members
For more information about PHP's URAC accreditations, visit URAC

Quality Improvement Program

PHP’s Quality Improvement Program is based on a written description that we review and update annually. The description provides the integrated framework for all quality improvement activities and provides overall guidance to the activities of the various standing quality committees. The objective of the Quality Improvement Program is effective and efficient implementation of the quality improvement process, defined as:
  • Quality Improvement Program Structure Development
  • Measurement
  • Communication and Coordination
  • Evaluation
  • Compliance with External Regulations and Standards

Structure

The Quality Improvement Program encompasses a system-wide approach to continuous quality assessment and improvement. It is integrated into the entire organization through standing committees with cross-functional representation and adhoc multidisciplinary teams. The structure is designed to promote integration and accountability toward achievement of the Quality Improvement Program goals. The PHP board of directors retains the authority, responsibility and accountability for PHP operations, including but not limited to the overall business plan and Quality Improvement and Utilization Management (UM) programs.

You may request more detailed information about Quality Improvement Program by contacting the Quality Management Department at 517.364.8400. 

Quality Improvement Suggestions

Physicians Health Plan supports continuous quality improvement, and we continually look for ways to improve our service. Please submit your ideas to:

Physicians Health Plan
Quality Improvement Team
PO Box 30377
Lansing, MI 48909-7877

Or, you may call our quality improvement team at 517.364.8400. 

HEDIS

PHP participates in HEDIS® (Healthcare Effectiveness Data and Information Set) reporting. HEDIS® is a set of standardized performance measures designed to ensure that purchasers and consumers have the information they need to reliably compare the performance of managed healthcare plans. It is sponsored, supported and maintained by the National Committee for Quality Assurance (NCQA) an independent, not-for-profit organization committed to evaluating and publicly reporting on the quality of managed care plans. 

 

CAHPS – 2017 Member Survey Results

Each year we participate in the CAHPS (Consumer Assessment of Healthcare Providers and Systems) 4.0H survey, which measures many aspects of member satisfaction. Members are asked a variety of questions about their feelings toward PHP, including their experience with Customer Service. For example, one question asks members, “in the last 12 months, how often was it easy to get the care, tests or treatment that you needed?” A health plan’s scores are based on the percentage of members who respond to questions with “usually” or “always.”