As stewards of the public trust and funds, PrimeWest Health is held accountable for the quality of the health care services we cover for our members. As such, audits occur on a regular basis and results are made available to the public. To learn more about audit standards or to see recent audit reports, click on the links below.
Annual Technical Report (ATR)
This report is the External Quality Review Organization's (EQRO) assessment of State and Federally mandated activities related to the unifying framework: structure, process, and outcomes. This framework serves as the foundation for the EQRO's recommendations to help organizations maintain and improve timeliness, quality, and access to health care services. The assessment consists of an inventory of activities and programs set forth in the Minnesota Department of Human Services/Managed Care Organization Contract and the Balanced Budget Act (BBA).
Consumer Assessment of Healthcare Providers and Systems (CAHPS®)1 Survey and Medicare Advantage Prescription Drug Plan (MA-PD) CAHPS Survey
The CAHPS Survey measures members' satisfaction with their care in areas such as claims processing, customer service, and getting needed care quickly.
Health Outcomes Survey (HOS) for PrimeWest Senior Health Complete (HMO SNP) and Prime Health Complete (HMO SNP)
The HOS survey is the only patient-reported outcomes measure in Medicare managed care. A baseline and two-year follow-up survey are used to categorize each participating member’s physical and mental health status as better, the same, or worse than expected, taking into account risk adjustment factors.
The Annual Report is sent to members each year. It is an overview of PrimeWest Health events, quality initiatives, and financial information from the past year.
Health Record Reviews/Site Visit Reports
PrimeWest Health performs regular Health Record Reviews and Site Visits at provider locations. These reports provide the results of the completed audits and site visits.
Quality Assurance Plan
This document presents the written Quality Assurance Plan and describes the PrimeWest Health Quality program. Our Quality Assurance Plan was developed in accordance with State and Federal requirements as well as National Committee for Quality Assurance (NCQA) standards.
Model of Care Summary Presentation
This presentation is a summary of the PrimeWest Health Model of Care for our Special Needs Plan members. It provides a general overview of the Model of Care.
1CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ)