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SoonerSelect Medical Scorecard - October


Member Satisfaction

Calendar Year 2025

Member Satisfaction is evaluated through CAHPS® Patient Experience Surveys.

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?

% Rating 8, 9 or 10

Adult: 74.7%

Child: 88.1%

CHIP: 86.1%

Adult: 75.6%

Child: 91.7%

CHIP: 86.8%

Adult: 73.3%

Child: 86.2%

CHIP: NA

Adult: 74.0%

Child: 74.9%

CHIP: NA

Getting care quickly

% Usually or Always

Adult: 80.8%

Child: 90.9%

CHIP: 82.8%

Adult: 78.4%

Child: 85.6%

CHIP: 85.8%

Adult: 85.3%

Child: 85.7%

CHIP: NA

Adult: 79.1%

Child: 93.4%

CHIP: NA

Getting needed care

% Usually or Always

Adult: 86.7%

Child: 84.6%

CHIP: 81.4%

Adult: 83.0%

Child: 87.1%

CHIP: 85.8%

Adult: 87.1%

Child: 85.5%

CHIP: NA

Adult: 77.5%

Child: 90.1%

CHIP: NA

How well doctors communicate

% Usually or Always

Adult: 92.6%

Child: 97.1%

CHIP: 94.7%

Adult: 98.0%

Child: 92.5%

CHIP: 94.9%

Adult: 94.3%

Child: 95.3%

CHIP: NA

Adult: 99.3%

Child: 98.7%

CHIP: NA

Health plan customer service

% Usually or Always

Adult: 93.8%

Child: 83.9%

CHIP: 88.6%

Adult: 92.7%

Child: 91.3%

CHIP: 92.0%

Adult: 91.5%

Child: 86.2%

CHIP: NA

Adult: 97.4%

Child: 91.1%

CHIP: NA


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

Overall satisfaction with HEALTH PLAN?

% Completely or Somewhat Satisfied

61.5% 64.5% 53.7% 53.7%*

How would you rate HEALTH PLAN compared to all other health plans you contract with?

% Well or Somewhat Above Average

 

39.0% 33.3% 17.5% 17.5%*

* Survey responses for provider experiences with Oklahoma Complete Health and Oklahoma Complete Health CSP are reported together.


Authorization of Services

May - July 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 100% 99.0%

98.6%

97.1%

Total % of Standard Prior Authorization Requests Denied

6.6% 19.9% 19.8% 9.9%

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:

  • Percentage of discharges for which the beneficiary received follow-up within 30 days after discharge
  • Percentage of discharges for which the beneficiary received follow-up within 7 days after discharge

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:

  • Percentage of discharges for which the beneficiary received follow-up within 30 days after discharge.
  • Percentage of discharges for which the beneficiary received follow-up within 7 days after discharge.

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. 

  • Well-Child Visits in the First 15 Months. Children who turned age 15 months during the measurement year: Six or more well-child visits. 
  • Well-Child Visits for Age 15 Months–30 Months. Children who turned age 30 months during the measurement year: Two or more well-child visits.Measure: Well-Child Visits in the First 30 Months of Life
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
Last Modified on Nov 17, 2025