Quality Improvement Program
SilverSummit Healthplan wants to make sure you and your family get the best care. Our goal is to help you stay healthy and feel better if you are sick or have a disability.We follow special rules from a group called the National Committee on Quality Assurance (NCQA) to make sure our care is safe and high quality.
Here’s what we do to help:
- Check doctors and providers before they join our network
- Make sure you can get the care you need
- Teach you about staying healthy and managing illnesses
- Send reminders for important checkups like physicals and cancer screenings
- Listen to your concerns about the care you received
- Ask for your opinion in a yearly Member Survey
We want to hear from you! Your answers help us improve our services.If you have questions about how we work or how we reward doctors, call Member Services at 1-844-366-2880, TTY: 1-844-804-6086, Relay 711.
The QI Program also reviews services provided to our members. We have clinical practice guidelines for certain conditions. If you would like a copy of these guidelines, give feedback, or to participate in our Members Advisory Board, please call us at 1-844-366-2880 (TTY/TDD 1-844-804-6086)
Quality Performance:
SilverSummit Healthplan’s Member Experience Results are available here:
SURVEY QUESTIONS | 2025 SCORE | 2024 SCORE |
Rating of Personal Doctor | 61.7% | 60.0% |
Rating of Specialist | 59.6% | 66.3% |
Getting Care, Tests or Treatments | 76.7% | 81.0% |
Getting Specialist Appointment | 74.8% | 78.8% |
Provided Information or Help | 82.5% | 81.9% |
Treated with Courtesy and Respect | 90.7% | 95.0% |
Doctor Explained Things | 93.4% | 95.7% |
Doctor Listened Carefully | 91.7% | 94.7% |
Doctor Showed Respect | 93.4% | 95.8% |
Doctor Spent Enough Time | 87.6% | 92.7% |
Advised to Quit Smoking | 63.4% | 53.8% |
Discussing Cessation Medications | 42.6% | 36.7% |
Discussing Cessation Strategies | 35.0% | 30.8% |
The Agency for Healthcare Research and Quality (AHRQ) has recently updated the Behavioral Health (BH) survey, transitioning it to the Outpatient Mental Health Survey (OPMHS).
This survey monitors patient’s experience with mental health care provided in outpatient settings.
BH ECHO Domains and Measures |
Getting Treatment Quickly How Well Clinician Communicate Informed About Treatment Options Access to Treatment and Information from Health Plan Office Wait Time Informed about Medication Side Effects Received Information about Managing Condition Informed about Patient Rights Ability to Refuse Medication and Treatment Rating of Counselling or Treatment |
OPMHS Domains and Measures: |
Getting Appointments for Prescription Medicines (Q3) Getting Mental Health Counseling (Q10, Q12) Communication with Mental Health Counselor (Q13, Q14) Goal Setting (Q16) Getting Help Between Appointments (Q21) Rating of Mental Health Counselor (Q22) Unmet Need for Mental Health Services (Q23) Financial Barriers to Mental Health Services (Q25) |
Due to the shift from BH Echo to OPMH, survey domain and questions are different. Please note changes as you compare year over year variances.
BH ECHO Survey Questions | 2024 SCORE | OPMH Survey Questions | 2025 SCORE |
Rating of Counseling or Treatment | 62.7% | Getting Mental Health Counseling | 57.8% |
How Well Clinicians Communicate | 82.8% | Rating Mental Health Counselor | 73.4% |
Informed About Treatment Options | 52.2% | Goal Setting | 86.0% |
Office Wait Time | 73.1% | Getting Help Between Appointments | 72.7% |
Informed About Medication Side Effects | 72.7% | Communication with Mental Health Counselor | 93.2% |
Received Information about Managing Condition | 68.6% | Financial Barriers to Mental Health Services | 20.8% |
Informed about Patient Rights | 82.4% | Unmet Need for Mental Health Services | 67.8% |
Ability to Refuse Medication and Treatment | 78.8% | Getting Appointments for Prescription Medicines | 64.7% |
Nevada Health Authority Quality Performance Information is also available here: https://www.nevadamedicaid.nv.gov/about/caseload-data/
RESPECTING YOUR CULTURE
SilverSummit Healthplan wants to make sure you feel respected and understood. We train our staff and doctors to give care that respects your culture, language, and beliefs.
Here’s what we do:
- We offer free help with language, including sign language and TTY services
- We teach our doctors and staff how race and culture can affect health
- We collect information about race and language to help us improve care
- We explain race and ethnicity choices so you can pick what fits you and your family
Member Services: 1-844-366-2880 • TTY: 1-844-804-6086, Relay 711
We think about all parts of who you are when planning your care, including:
- Race and country you’re from
- Language you speak
- Religion and traditions
- Age and gender
- Abilities and how you see the world
We also have signs and papers in many languages at our offices.
SilverSummit Healthplan believes working with the community is very important when making programs that respect different cultures. That’s why we created a group called the Behavioral Health Impact Committee. This group helps make sure everyone gets fair and kind mental health care, no matter who they are or where they come from. The Committee finds ways to make it easier for people to get help, checks how well our Cultural Competence Plan is working, and helps improve services that support healing for people from many different backgrounds.
Join Us!
The Behavioral Health Impact Committee meets online every few months, and anyone who is interested can join. If you want to come to a meeting, please email Dawnesha.Powell@SilverSummitHealthplan.com