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Appointment Wait Times - Primary Medical/Surgical Care

Wellmark Health Plan of Iowa strives to ensure that all members have access to their primary care practitioners 24 hours a day, 7 days a week, and that members can obtain an appointment within a reasonable period of time. 

 
Policy Example Measurement
Primary care offices shall schedule a preventive/health maintenance appointment within 4-8 weeks Physicals, immunizations, well-female exam, well-child visit Based on the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) member satisfaction ratings, the percentage of members that report that they "always" or "usually" get care when they needed it will be at or exceed the 90th percentile Quality Compass®.
Primary care offices shall schedule a primary care appointment within 14 calendar days Hypertension follow-up, joint pain/arthritis, skin rash or acne, headaches Based on the Consumer Assessment of Healthcare Providers and Systems (CAHPS) member satisfaction ratings, the percentage of members that report that they "always" or "usually" get care when they needed it will be at or exceed the 90th percentile Quality Compass.
Primary care offices shall schedule an urgent care appointment within 24 hours Conditions with sudden onset of symptoms or deterioration such as urinary tract infection, upper respiratory infection, breast lump, bloody stools, severe pain Based on the Consumer Assessment of Healthcare Providers and Systems (CAHPS) member satisfaction ratings, the percentage of members that report that they "always" or "usually" get care when they needed it right away will be at or exceed the 90th percentile Quality Compass.
Members will be able to receive emergency care immediately Emergency care 100% of members are able to receive emergency care immediately

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


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