Our Mission is to "Provide managed care solutions to improve outcomes, keep costs low and improve the health and wellness of the communities we serve". At ADVANTAGE we weave quality improvement into everything we do. We do this by measuring where we are now, and looking forward to where we want to be.
ADVANTAGE Health Solutions, Inc.sm is accredited by the National Committee for Quality Assurance (NCQA). NCQA awards accreditation status to organizations with programs for service and clinical quality that meet or exceed their rigorous requirements for consumer protection and quality improvement.
Our Quality Improvement Program is created annually. It is then reviewed by our Physician Advisory Committee and approved by our Board of Directors. To review our program you can click on the link below or call our Quality Improvement Department at 1-877-901-2237 ext. 6736. We would be happy to send you a copy!
ADVANTAGE Health Solutions, Inc has developed the Preventive Health Guidelines for both pediatrics and adults. These guidelines are based on nationally recognized standards of care and are provided to our members to ensure they remain updated on maintaining their own personal health through recommended preventative practices. The Preventive Health Guidelines include recommendations for yearly screenings as well as education and counseling with your physician.
Each year the Preventive Health Guidelines are updated and approved by our Physicians Advisory Committee (PAC) in late February. This committee is made up of practicing physicians that work within our health care networks to help establish an overall standard of excellence for your health care needs. If changes occur during the year, they will be updated appropriately throughout the year.
Preventative Health Guidelines for Adults
Preventative Health Guidelines for Children
Preventative Health Guidelines for Pregnacy
What is a screening? A screening is looking for a problem before a person has any symptoms.
Breast Cancer Screening: If you are a woman and between 40-69 years old, you need to get a mammogram to screen for breast cancer at least once every two years.
Colorectal Screening: If you are between the ages 50-80, you need to get one or more of the following colorectal screenings; Fecal occult blood test yearly, flexible sigmoidoscopy every five years, double contrast barium enema every five years, colonoscopy every 10 years. Please speak with your doctor to find out which screening is right for you!
Cervical Cancer Screening: If you are a woman between the ages 21-64 years old, you need to be screened for cervical cancer at least every three years. This screening is called a 'Pap smear' and requires a visit to your doctor's office. When abnormal tissue or cancer is found early, it may be easier to treat. By the time symptoms appear, cancer may have begun to spread.
Glaucoma Screening: If you are 65 or older, you need to be screened for glaucoma. Studies have shown that early detection and treatment of glaucoma, before it causes major vision loss, is the best way to control the disease.
Please view our Preventative Health Guidelines for a complete list of age appropriate screenings and education/counseling.
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Healthcare Effectiveness Data and Information Set - So what it is really?
HEDIS was developed by NCQA so they could have a way to measure how effective a health plan is at providing its members with standard of care. These measures include; preventative health screenings and immunizations, appropriate treatment for acute and chronic conditions and monitoring and follow up on care given. These measures are used by 90% of America's health plans so they are a good indicator of how we are doing.
These measures are collected annually and reflect how well we ensure you receive the highest standard of care possible! As you can see, ADVANTAGE has scored consistently above the 50th percentile. This means that of all the health plans in the United States, we are above average in assuring the care required for these measures are completed.
What is CAHPS? Consumer Assessment of Healthcare Providers and Systems - So what is CAHPS really?
The term CAHPS refers to standardized survey that asks you as a consumer and patient to evaluate the interpersonal aspects of health care. Health plans across the United States use CAHPS to monitor how well you are satisfied with the care and service you receive from your health plan and from your healthcare provider.
This survey is completed annually. We hope that if you receive a survey you will participate and answer honestly. By reviewing this information and making the necessary improvements we are striving to be the best health plan in Indiana!
Clinical Practice Guidelines (CPG) are systematically developed standards to assist the practitioner and patient in making decisions about appropriate health care for specific conditions. The CPG's are developed by organizations that use rigorous review, analysis of peer reviewed research and the use of expert teams. ADVANTAGE Health Solutions, Inc.sm, (AHS) Physician Advisory Committee has reviewed and adopted the following CPG's to be used by our network physicians. These CPG's are also the basis of our disease management programs.
Guideline
Action Plan
Provider SOAP
Keeping Track Of Your Weight
Keeping Track Of Your Heart Health
Your Guide To Living Well With Heart Disease
Diet Exercise
Goals
Quick Guidelines
Additional Care
Pharmacy
Guidelines
How Spirometry Tests Work
Calculator
Screening PHQ-9
Guide
As part of the ADVANTAGE Immunization Schedule, we have adopted and combined both the Childhood and Adult Immunization schedule into one document for your convenience. This schedule indicates the recommended ages for routine administration of currently licensed vaccines for children through age 18 years and adults. ADVANTAGE Health Solutions, Inc adopts the most current immunization schedule approved by the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Pediatrics (AAP). Additional vaccines may be licensed and recommended during the year, in which ADVANTAGE will update our Immunization Schedule accordingly. This schedule is reviewed yearly in conjunction with many U.S. Government Organizations including the Centers for Disease Control (CDC) and the U.S. Department of Health & Human Services (HHS).
Please feel free to view these immunization practices to assure your child is receiving proper age appropriate vaccinations.
Childhood Schedule (Birth-6 years)
Adolescent Schedule (7-18 years)
Catch-Up Schedule (4 month-18 years)
Adult Schedule (over 18 years old)
This information is not a description of benefits. Please refer to your benefits description materials for the terms, limitations, and exclusions of your coverage. Use this as a guide in scheduling routine care appointments for your family. Your physician can make more specific recommendations based on your health risks.
