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)
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
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/
Member Advisory Board (MAB) Meetings
SilverSummit Healthplan holds meetings four times a each year. These meetings give Members a chance to share their thoughts about their health care and the services they receive.
Quarter 1, 2026
Date: March 26
Time: 12:30–1:30 p.m.
Location: In person and on Zoom
About the Meeting
SilverSummit Healthplan met with members for the Quarter 1 Member Advisory Board meeting.
- Members joined in person and on Zoom.
- There were 22 members at the meeting.
- SilverSummit welcomed members and listened to their questions.
Talking With Members About Health Care
The meeting focused on preventive care. SilverSummit talked about how checkups and tests help find health problems early and keep people healthy.
SilverSummit shared why preventive care is important.
They gave easy tips to help members at doctor visits:
- Bring a list of medicines
- Write down questions
- Get lab tests when a doctor asks
SilverSummit also explained where to go for care:
- Primary Care Provider: For regular care
- Nurse Advice Line (24 hours): For health questions
- Urgent Care: When your doctor’s office is closed
- Emergency Room: For serious emergencies
Staying Connected with Members
SilverSummit helps members get care:
- Phone calls about checkups and tests
- Mail with health plan and benefit information
- Outreach Members to answers questions
These services help members with rides, resources or finding doctors, especially in rural areas.
Member Questions and Shared Concerns
Benefits
- Members asked about a summer camp benefit for children.
- SilverSummit said this is a benefit and would follow up.
Transportation
- Members asked about rides to mental health visits and long trips from Ely to Salt Lake City
- SilverSummit shared that some long trips may need approval.
- Members were told to call early to allow time for review.
- One member shared it can be hard to reach SafeRide by phone.
- SilverSummit thanked the member for sharing that concern
- SilverSummit suggested using the SafeRide mobile app after the first call.
In‑Home Health Visits
- Members asked about calls offering in‑home health checks.
- SilverSummit shared these visits are optional and not required.
- In-home is meant to support members
Communication and Finding Care
- One member shared that phone calls can be hard due to a speech issue.
- SilverSummit explained that Member Services can add a trusted helper.
- Members shared trouble finding nearby doctors.
- SilverSummit shared there is a new eye doctor in the network.
- SilverSummit also shared that teams are working to improve access to care.
Next Steps
- SilverSummit answered questions and collected contact details to follow up.
- SilverSummit thanked members for sharing their thoughts and ideas.
- SilverSummit shared their commitment to listen and improve care for members.
Member Resources
- SafeRide (Non‑Emergency Transportation): 1-855‑955‑7433
- SilverSummit Medicaid Website: https://www.silversummithealthplan.com/members/medicaid.html
- Value‑Added Benefits: https://www.silversummithealthplan.com/members/medicaid/benefits-services/benefits-overview.html
- Quality Improvement:
https://www.silversummithealthplan.com/members/medicaid/resources/quality-improvement.html - Member Services: 1-844‑366‑2880
Meeting ended at 1:24 p.m.
Topics Discussed in 2025:
- Preventive Care and Staying Healthy
- Members learned why regular check-ups is important
This included:
- Doctor visits
- Vaccines
- Health screenings
- Well child visits
The Quality Team shared ways they help Members to stay healthy.
These reminders include:
- Phone calls
- Letters
- Text messages
Member Outreach and Support
SilverSummit shared how staff help Members:
- Schedule doctor visits
- Find doctors
- Solving problems like transportation or long wait times
Members also shared ideas to make letters, texts, and reminders easier to understand.
Knowing Where to Get Care
Members learned when to use:
- A primary care doctor
- Urgent care
- The emergency room
- The 24/7 Nurse Advice Line
This helps Members get the right care at the right time.
Health Programs and Benefits
Members received updates on helpful programs, including:
- My Health Pays™ rewards
- Over the counter (OTC) benefits
- EPSDT services for children and teens
- At home test kits for certain health screenings
Members asked questions about how these benefits work and how to use them.
Care in the Community
Community partners shared information about services such as:
- In home care
- Care coordination
- Support services
These services help Members get care, medicine, and other support at no extra cost.
Health Equity and Respect
SilverSummit talked about treating all Members with fairness and respect.
Topics included:
- Language help
- Culturally respectful care
- Reducing health gaps in different communities
Member Questions and Feedback
Members asked questions about:
- Using rewards and benefits
- Finding doctors and specialists
- Medicaid benefits
- Avoiding spam calls
- Dental benefits
- Pharmacy services
SilverSummit staff answered questions and shared helpful resources.
How Members’ Feedback Is Used
Feedback from the Member Advisory Board helps SilverSummit:
- Improve how we talk with Members
- Make benefits easier to understand
- Help Members get care and support
- Strengthen programs that matter most
SilverSummit thanked all Members who joined the 2025 MAB meetings and helped make our services better.