Network Performance

The Genesee Health System's Prepaid Inpatient Health Plan monitors individual providers and the network as a whole in a number of ways to ensure that the services provided to the individuals we serve are delivered effectively, efficiently, and in accordance with the standards prescribed by regulatory, governing, and accrediting bodies.

This webpage will provide you with a snapshot of our network performance as well as GHS PIHP performance data from the Michigan Department of Community Health.  

Performance Indicators:
MDCH Site Review:
The Michigan Department of Community Health conducts site reviews of the PIHPs and their provider networks to measure compliance with state and federal standards. MDCH also contracts with the Health Services Advisory Group (HSAG) to perform external quality reviews which aggregate and analyze specific elements of service data related to the Balanced Budget Act of 1997. The following documents provide a snapshot of some of those review results.
Network Report Card:

Our Network Report Card, also published as part of CMH’s Annual Report, is a way to summarize all of the information about providers. Each provider receives a score from 0 to 100 on the following categories:

  • Clinical quality
  • Organizational / regulatory compliance
  • Timely access
  • Clinical outcomes
  • Satisfaction

Stakeholder Survey:
We also welcome feedback from stakeholders - people and organizations to whom services and outcomes matter – on a continual basis. This helps managers to know and understand community perceptions and needs, and tailor network development activities accordingly.
Claims Verification:
Consumer Satisfaction:
We value feedback from the individuals that we serve. We measure consumer satisfaction and use survey results like the ones published below to identify what we are doing well and what we need to improve.
Quality of Care Audits
Quality audits show how well providers meet local, state and federal standards for quality of care. Below are some of the Quality of Care audit results.