Network Directory Ratings
Health Net Federal Services, LLC (HNFS) offers information on physicians and other health care providers to assist you in the selection of practitioners.
RowdMap (gold star designation)
It is estimated about 30 percent of health care spending goes towards unnecessary care. HNFS has partnered with RowdMap, a recognized analytics subsidiary of Cotiviti Holdings, Inc., to help us rank providers based on their patterns of clinical practice.
According to RowdMap criteria, high value providers:
- Demonstrate thoughtful use of diagnostic tests and procedures.
- Begin with conservative care, performing surgery or other maximally intense options only when the outcome is likely to be better than alternative treatment options.
- Perform more procedures that represent good value than his or her peers.
- If surgeons, perform surgery on appropriate patients in the optimal setting, with fewer complications and readmissions.
- Manage pain with lower-risk medications.
- Align with other high value providers in their geographic area.
HNFS designates high value providers with a RowdMap rating of 1 or 2 (out of 5) in its network provider directory with a gold star.
Keep in mind, if a physician or other health care provider does not have the star designation, it does not mean the provider does not provide quality care. All network providers must meet TRICARE and HNFS stringent quality and credentialing requirements.
Visit www.cotiviti.com for additional information.
Patient-Centered Medical Home Designation
The Patient-Centered Medical Home is a model of care that puts patients at the forefront of care. Patient-Centered Medical Homes are designed to build better relationships between people and their clinical care teams, resulting in improved quality, patient experience and staff satisfaction, all while reducing health care costs. The National Committee for Quality Assurance (NCQA), a private, non-profit organization dedicated to improving health care quality, accredits and certifies a wide range of health care organizations. Its Patient-Centered Medical Home Recognition Program highlights primary care providers who have made a commitment to:
- Help understand treatment options and are a partner in decisions about your care.
- Get better access through expanded hours and the web.
- Have providers work in teams to prevent problems and manage chronic conditions to keep patients healthy.
HNFS designates NCQA Patient-Centered Medical Home recognition in its network provider directory with the NCQA emblem.
Performance-Based Maternity Ratings
The Leapfrog Group, a national nonprofit organization established to drive improvements in health care quality and safety, conducts an annual hospital survey and compares reported hospital performance against nationally-recognized benchmarks for five maternity care measures: early elective deliveries, Caesarian sections, episiotomies, maternity care processes, and high-risk deliveries. Participation in The Leapfrog Group’s survey is voluntary. HNFS’ network provider directory identifies those providers awarded with a rating of High Value, Value or High-Risk Delivery with a corresponding icon, based upon the most current survey data posted by The Leapfrog Group on its public website.
A Value rating indicates a facility that has been assigned a performance rating of "Fully Meets the Standard." This rating is given to network hospitals that meet three out of four core metrics in early elective deliveries, C-sections, episiotomies, and maternity care processes.
A High Value rating indicates a facility that has achieved a satisfactory performance rating on all four core metrics in early elective deliveries, C-sections, episiotomies, and maternity care processes.
A High-Risk Delivery
indicates a facility that has a minimum of 50 very low birth weight deliveries per year.
If a hospital does not have a stork designation, it does not mean the facility does not provide quality care. All network providers must meet TRICARE and HNFS stringent quality and credentialing requirements. To learn more about The Leapfrog Group and survey participation, scoring and results, please visit www.leapfroggroup.org.