SoonerSelect Medical Scorecard - April
Member Satisfaction
Calendar Year 2025
Member Satisfaction is evaluated through CAHPS® Patient Experience Surveys. The results from the first CAHPS® surveys will be available in the fall of 2025.
| Metric | Humana Healthy Horizons of Oklahoma | Aetna Better Health | Oklahoma Complete Health | Oklahoma Complete Health – CSP |
|---|---|---|---|---|
| Using any number from 0 to 10, where 0 is the worst health plan possible and 10 is the best health plan possible, what number would you use to rate your health plan? | Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 |
| Getting care quickly | Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 |
| Getting needed care | Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 |
| How well doctors communicate | Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 |
| Health plan customer service | Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 |
Provider Satisfaction
Calendar Year 2025
Provider satisfaction is evaluated through provider surveys. The results of the first round of surveys will be available during the fall of 2025.
| Metric | Humana Healthy Horizons of Oklahoma | Aetna Better Health | Oklahoma Complete Health | Oklahoma Complete Health – CSP |
|---|---|---|---|---|
| How would you rate HEALTH PLAN compared to all other health plans you contract with? | Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 |
How would you rate HEALTH PLAN compared to all other health plans you contract with? |
Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 |
Authorization of Services
November 2024 - January 2025
Prior authorization is a process that allows the managed care plans to approve treatment before it begins. Each plan has a different process for authorizing provided services, so reported numbers may not be comparable with other plans. Appropriate care can mean some level of authorization denials are expected. Pharmacy prior authorizations are excluded. Accuracy of data is dependent on each plan’s ability to report.
| Metric | Humana Healthy Horizons of Oklahoma | Aetna Better Health | Oklahoma Complete Health | Oklahoma Complete Health – CSP |
|---|---|---|---|---|
| Total % of Standard Prior Authorization Requests Completed Within 72 Hours | 98.8% | 95.6% | 74.3% |
84.1% |
Total % of Standard Prior Authorization Requests Denied |
4.5% | 10.3% | 18.1% | 24.6% |
Quality Metrics
Standardized metrics from nationally recognized organizations are used to evaluate the quality of managed care performance.
| Metric | Humana Healthy Horizons of Oklahoma | Aetna Better Health | Oklahoma Complete Health | Oklahoma Complete Health – CSP |
|---|---|---|---|---|
Percentage of discharges for beneficiaries ages 6 to 17 who were hospitalized for treatment of selected mental illness or intentional self-harm diagnoses and who had a follow-up visit with a mental health provider. Two rates are reported:
Measure: Follow-Up After Hospitalization for Mental Illness (FUH) |
Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 |
Percentage of discharges for beneficiaries age 18 and older who were hospitalized for treatment of selected mental illness or intentional self-harm diagnoses and who had a follow-up visit with a mental health provider. Two rates are reported:
Measure: Follow-Up After Hospitalization for Mental Illness (FUH) |
Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 |
Percentage of children who had the following number of well-child visits with a primary care practitioner (PCP) during the last 15 months.
|
Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 |
Percentage of children ages 3 to 21 who had at least one comprehensive well-care visit with a primary care practitioner (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement year. Measure: Child and Adolescent Well-Care Visits (WCV) |
Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 |
The percentage of beneficiaries ages 45 to 75 years who had appropriate screening for colorectal cancer. Measure: Colorectal Cancer Screening (COL-E) |
Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 | N/A |
Patients 20 years and older who had an ambulatory or preventive care visit during the measurement year Measure: Adults’ Access to Preventive/Ambulatory Health Services (AAP) |
Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 | N/A |
Percentage of children age 2 who have completed the Combo 3 series vaccines by their second birthday. Measure: Childhood Immunization Status (CIS-CH) Combination Three (3) |
Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 |
Percentage of children and adolescents ages 1 to 17 who had a new prescription for an antipsychotic medication and had documentation of psychosocial care as first-line treatment. Measure: Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP) |
N/A |
N/A |
N/A |
Data Available Q4 2025 |
Percentage of children 2 years of age who had one or more capillary or venous lead blood test for lead poisoning by their second birthday Measure: Lead Screening in Children (LSC-CH) |
Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 | Data Available Q4 2025 |
