• Resources
• LDH Resources

LDH Resources

• 2013 Managed Care Transparency Report

  Details:

  January 31, 2015

  • Legislative & Governmental Relations
  • Medicaid
  • Managed Care

  Managed Care 1.0 Amerigroup Healthy Blue Community Health Solutions LaCare AmeriHealth Caritas Louisiana Healthcare Connections UnitedHealthcare Community Plan Act 212 of the 2013 Regular Session of the Louisiana Legislature requires the Louisiana Department of Health and Hospitals (DHH) to submit annual reports concerning the Bayou Health program to the Legislature’s Senate and House Committees on Health and Welfare. The following Bayou Health Transparency Report: Calendar Year (CY) 2013 is intended to provide all information outlined in Act 212 for the second annual report to the Legislature. This report presents information on the Bayou Health program during the 2013 calendar year. Information and data for inclusion in this report were collected and provided by the contracted Bayou Health plans. The health plans’ internal policies and procedures for collection of data were validated by DHH’s contracted external quality review organization (EQRO), Island Peer Review Organization (IPRO), in conjunction with 2013 external quality reviews. An additional validation was performed by either the National Committee for Quality Assurance (NCQA) or the Utilization Review Accreditation Commission (URAC) as part of the contractually required health plan accreditation process. Plans are contractually required to obtain accreditation from either NCQA or URAC for their Bayou Health plan serving Louisiana members. All Bayou Health plans have obtained accreditation from those national accrediting bodies NCQA or URAC, which are rigorous processes involving comprehensive reviews of the plans’ policies, procedures and practices.

  Downloadable Assets:

  2013 Managed Care Transparency Report Appendix I: Number of Healthcare Providers by Provider Type, Plan, Service Area and Entity Type Appendix II: Number of Healthcare Providers by Provider Specialty, Plan, Service Area and Entity Type Appendix III: Number of Members Enrolled by Plan, Eligibility Group and Month Appendix IV: Total and Average per Member per Month Payment to Each Plan by Month Appendix V: Amerigroup Louisiana Medical Loss Ratio Report Appendix VI: AmeriHealth Caritas Louisiana Medical Loss Ratio Report Appendix VII: Louisiana Healthcare Connections Medical Loss Ratio Report Appendix VIII: Amerigroup Louisiana 2014 CAHPS Adult Medicaid Member Satisfaction Survey Appendix IX: Amerigroup Louisiana 2014 CAHPS Child Medicaid with CCC Member Satisfaction Survey Appendix X: AmeriHealth Caritas Louisiana 2014 CAHPS Adult Medicaid Member Satisfaction Survey Appendix XI: AmeriHealth Caritas Louisiana 2014 CAHPS Child Medicaid with CCC Member Satisfaction Survey Appendix XII: Louisiana Healthcare Connections 2014 Medicaid Adult CAHPS Appendix XIII: Louisiana Healthcare Connections 2014 Medicaid Child with CCC CAHPS Appendix XIV: Community Health Solutions of Louisiana 2014 CAHPS 5.0H Adult Medicaid Summary Report Appendix XV: Community Health Solutions of Louisiana 2014 CAHPS 5.0H Child Medicaid with Chronic Conditions Report Appendix XVI: UnitedHealthcare of Louisiana, Inc. 2014 HEDIS®/CAHPS Health Plan Survey Adult Medicaid Version Appendix XVII: UnitedHealthcare of Louisiana, Inc. 2014 HEDIS®/CAHPS Health Plan Survey Child Medicaid with CCC Measure Version Appendix XVIII: Amerigroup 2014 Provider Satisfaction Survey Report Appendix XIX: AmeriHealth Caritas Louisiana 2014 Provider Satisfaction Survey Report Appendix XX: Louisiana Healthcare Connections 2014 Provider Satisfaction Report Appendix XXI: Community Health Solutions of Louisiana 2014 Provider Satisfaction Survey Report Appendix XXII: UnitedHealthcare Community Plan 2014 Provider Satisfaction Survey Report Appendix XXIII: Amerigroup Louisiana, Inc. Audited Financial Statement Appendix XXIV: AmeriHealth Caritas Louisiana Audited Financial Statement Appendix XXV: Louisiana Healthcare Connections, Inc. Audited Financial Statement Appendix XXVI: Community Health Solutions of Louisiana Plan Audited Financial Statement Appendix XXVII: UnitedHealthcare of Louisiana, Inc. Audited Financial Statement Appendix XXVIII: Louisiana Shared Savings Program Interim Savings Determination for Program Year 1 Appendix XXIX: Number of Members Who Received Unduplicated Medicaid Services by Provider Specialty and Plan Appendix XXX: Amerigroup Louisiana, Inc. 2013 Pharmacy Report Appendix XXXI: AmeriHealth Caritas Louisiana 2013 Pharmacy Report Appendix XXXII: Louisiana Healthcare Connections 2013 Pharmacy Report