How Well Do You Know

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Across
  1. 3. is an annual survey used by NCQA to assess the understanding and experience of members with the healthcare they received.
  2. 4. Management is the evaluation of the appropriateness, medical necessity and efficiency of health care services and procedures according to established criteria or guidelines.
  3. 6. Management Program proactively targets members with complex needs and those having an acute event or hospitalization with chronic medical conditions, as well as identifies those at risk for incurring high costs.
  4. 8. program engages members and the community to improve their health in all stages of life by providing tools and support to help them better manage their health
  5. 10. - assesses and reports on the quality of managed care plans, which allows purchasers and consumers to compare plans based on quality and make more informed healthcare purchasing decisions.
Down
  1. 1. - is the national Blue Cross and Blue Shield Benefit Plan for federal employees and retirees. Members are managed by the Blue plan in the state where the member receives services.
  2. 2. is a comprehensive evaluation process in which a health care organization’s systems, processes and performance are examined by an impartial external organization
  3. 5. Management to support our customers by serving as a health advocate.
  4. 7. - Found in Section 1311(c)(3) of the Affordable Care Act directs the HHS Secretary to develop a system that rates health plans based on relative quality and price.
  5. 9. - Star Ratings are assigned annually by the Center for Medicare Services (CMS). Star Rating gives an overall rating of the health plan’s quality and performance for the types of services each health plan offers.