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About Network Health

Quality You Can Trust

Quality Program Information

Quality is engrained within the culture of Network Health and the work of each employee, but at Network Health, we do have a specific department that focuses on improving the quality of health care services you receive. Each year, our quality health integration department updates its quality improvement program structure which includes the following.

  • A written description of the quality improvement program
    • Specifically addressing behavioral health care
    • Specifically addressing patient safety
  • The structure of the quality improvement program, accountable to the Board of Directors
  • A designated physician who has substantial involvement in the quality improvement program
  • A designated behavioral health care professional who is involved in behavioral health care aspects of the program
  • A quality improvement committee that oversees the function of the organization
  • The specific role, structure and function of the quality improvement committee and other connected committees, including how often they meet
  • An annual quality work plan, including progress toward accomplishing goals
  • A description of resources the organization devotes to the quality improvement program

For more information about Network Health's Quality Improvement Program, email us at [email protected].

The National Committee for Quality Assurance (NCQA) Rates Medicare plans

NCQA rates Medicare insurance plans based on their combined Healthcare Effectiveness and Data Information Set (HEDIS ®) and the Consumer Assessment of Healthcare Providers and Systems (CAHPS ®) and NCQA Accreditation standards scores. Accreditation status is as of August 5, 2021.

Network Health's NCQA Ratings for 2020-2021 are listed in the tables below.

(5 is the highest performance)


Consumer Satisfaction (Score - 4.5)
Measure Rating
Getting Care 4.5
Getting Care Quickly 4
Getting Needed Care 5
Satisfaction with Plan Physicians 4.5
Rating of Personal Doctor 5
Rating of Specialist Seen Most Often 3
Rating of All Health Care 5
Coordination of Care 5
Satisfaction with Plan Services 3
Rating of Health Plan 3
Measure Rating
Breast Cancer Screening 4
Colorectal Cancer Screening 4
Pneumonia Vaccinations 5
Flu Vaccinations 4
Measure Rating
Diabetes 4.5
Diabetes Care - Eye Exam 4
Diabetes Care - Blood Pressure Control (<140/90 mm Hg) 5
Diabetes Care - HbA1c Control (<8.0%) 5
Patients with Diabetes - Received Statin Therapy 3
Patients with Diabetes - Statin Adherence 80% 4
Heart Disease 4.5
Patients with Cardiovascular Disease - Received Statin Therapy 3
Patients with Cardiovascular Disease - Statin Adherence 80% 4
Controlling High Blood Pressure 5
Mental and Behavioral Health 3.5
Depression: Adhering to medication for 6 months 4
Follow-Up After Hospitalization for Mental Illness 3
Follow-Up After Emergency Department for Mental Illness 2
Follow-Up After Emergency Department for Alcohol and Other Drug Abuse or Dependence 5
Initiation and Engagement of Alcohol and Other Drug Dependence Treatment 3
Other Treatment Measures
Management for COPD Exacerbation - Bronchodilators 2
Management for COPD Exacerbation - Systemic Corticosteroids 4
Managing the Risk of Falls 2
Managing Osteoporosis in Women After a Fracture 2
Avoiding High-Risk Medications for Older Adults 4
Avoiding Non-Recommended Prostate Cancer Screening in Older Men 3
Avoiding Potentially Harmful Drug-Disease Interactions in Elderly 4
Follow-Up After Emergency Department for Multiple High-Risk Chronic Conditions 4
Potentially Inappropriate Use of Opioids at High Dosage 3
Potentially Inappropriate Use of Opioids from Multiple Prescribers and Pharmacies 3
Transition of Care - Notification of Inpatient Admission 5
Transition of Care - Receipt of Discharge Information 5
Transition of Care - Patient Engagement After Inpatient Discharge 5
Transition of Care - Medication Reconciliation Post-Discharge 5

The source for data reported above is Quality Compass© and is used with the permission of the National Committee for Quality Assurance (NCQA). Any analysis, interpretation, or conclusion based on the data is solely that of the authors, and NCQA specifically disclaims any responsibility for any such analysis, interpretation, or conclusion. Quality Compass is a trademark of NCQA.

HEDIS ® is a registered trademark of the National Committee for Quality Assurance (NCQA).
CAHPS ® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).

Star Ratings Information

The Centers for Medicare and Medicaid Services (CMS) uses a five-star quality rating system to measure Medicare patients' experiences with their health plans and the health care system. This rating system applies to Medicare Advantage (MA) plans throughout the nation. Our members appreciate our service and coverage—that’s why 96 percent stayed with us last year.* For 2022, Network Health earned a 5 out of 5 Star rating for our Medicare Advantage PPO plans—Medicare’s highest possible rating**.

Network Health Medicare PPO Star Ratings for 2022 are listed in the tables below.

(5 is the highest performance)


Staying Healthy
Measure Rating
Breast Cancer Screening 5
Colorectal Cancer Screening 5
Annual Flu Vaccine 4
Monitoring Physical Activity 3
Measure Rating
Special Needs Plan (SNP) Care Management 4
Care for Older Adults - Medication Review 5
Care for Older Adults - Pain Assessment 5
Osteoporosis Management in Women who had a Fracture 2
Diabetes Care - Eye Exam 5
Diabetes Care - Kidney Disease Monitoring 5
Diabetes Care - Blood Sugar Controlled 5
Rheumatoid Arthritis Management 5
Reducing the Risk of Falling 2
Improving Bladder Control 4
Medication Reconciliation Post-Discharge 5
Statin Therapy for Patients with Cardiovascular Disease 3
Measure Rating
Getting Needed Care 5
Getting Appointments and Care Quickly 5
Customer Service 5
Rating of Health Care Quality 5
Rating of Health Plan 4
Care Coordination 5
Measure Rating
Complaints about the Health Plan 5
Members Opting to Leave the Plan 5
Health Plan Quality Improvement 4
Measure Rating
Plan Makes Timely Decisions About Appeals 4
Reviewing Appeals Decisions 3
Call Center - Foreign Language Interpreter and TTY Availability 5
Measure Rating
Call Center - Foreign Language Interpreter and TTY Availability 5
Measure Rating
Complaints about the Drug Plan 5
Members Choosing to Leave the Plan 5
Drug Plan Quality Improvement 5
Measure Rating
Rating of Drug Plan 4
Getting Needed Prescription Drugs 5
Measure Rating
MPF Price Accuracy 5
Medication Adherence for Diabetes Medications 5
Medication Adherence for Hypertension (RAS antagonists) 5
Medication for Adherence for Cholesterol (Statins) 5
MTM Program Completion Rate for CMR 4
Statin Use in Persons with Diabetes (SUPD) 4

*Based on the percentage of Network Health Medicare Advantage (PPO) members who stayed on the plan for 2021, for coverage starting January 2021.

**See our 2023 Star Rating Information for Network Health PPO Medicare Advantage Plans, and Network Prime (MSA) plans. (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).

Network Health
1570 Midway Place
Menasha, WI 54952
Mon., Wed.-Fri.: 8 a.m. to 5 p.m.
Tuesday: 8 a.m. to 4 p.m.

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