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Access To Care

March 12, 2026, 2:50 pm

Cox HealthPlans (CHP) is committed to ensuring that members have access to and receive primary care and behavioral health services in a timely manner. Standards are also in place for telephone access to member services. CHP monitors access through a variety of measures, including appointment and office wait times, complaints, and responses from our member satisfaction surveys.

Access and availability standards are shared with members and providers through Provider Manuals and Member Handbooks. CHP monitors access and availability performance and completes a thorough analysis to check for concerns or opportunities for improvement each year, taking action as needed to improve access to care.

CHP’s access standards and measures are outlined in the table below with results from the 2025 CAHPS, Marketplace CAHPS, and CAHPS-like surveys.

 

Practitioner Type

Goal

Result

      Medical Care

Regular and routine care

CAHPS-like survey Q5, QHP Enrollee Survey “getting needed care”: 75% of members reported that they “always” or “usually” get an appointment for a check-up or routine care at a doctor’s office or clinic as soon as they needed it.

Review of Member Complaints

CAHPS: 83% of members reported that they “always” or “usually”

 

Marketplace CAHPS: 72.4% of members reported that they “always” or “usually”

 

CAHPS-like: 80.7% of members reported that they “always” or “usually”

 

No member complaints

 

 

Routine, symptomatic care

CAHPS Q3, QHP Enrollee Survey “getting care quickly”: 75% of members reported they “always” or “usually” get an appointment for health care at a doctor’s office or clinic as soon as they needed it.

 

Review of Member Complaints

CAHPS: 85% of members reported that they “always” or “usually”

 

Marketplace CAHPS: 75.6% of members reported that they “always” or “usually”

 

CAHPS-like: 78.7% of members reported that they “always” or “usually”

 

 

No member complaints

Urgent care

CAHPS Q3, QHP Enrollee Survey “getting care quickly”: 75% of members reported they “always” or “usually” get an appointment for health care at a doctor’s office or clinic as soon as they needed it.

 

Review of Member Complaints

CAHPS: 85% of members reported that they “always” or “usually”

 

Marketplace CAHPS: 75.6% of members reported that they “always” or “usually”

 

CAHPS-like: 78.7% of members reported that they “always” or “usually”

 

No member complaints

Obstetrical care

Review of member complaints

No member complaints

After-hours care

90% on after-hours call audit

 

Review of member complaints

100% through walk-in clinics and through CoxHealth Virtual Visits, No member complaints

Behavioral Health

Routine care

Review of hours for behavioral health, review of member complaints

No member complaints

Screening / Triage

Review of member complaints

100% through same day screening at Burrell Access Center, no member complaints

Urgent care

Review of hours for behavioral health and urgent care, review of member complaints

100% through urgent care open 24/7, no member complaints

Non-life-threatening emergency care

Immediate ER Access, review of member complaints

100% though any ED

Life-threatening emergency care

Immediate ER access

Yes, available through any ED

CHP Member Services

Telephone access to member services

Call answered within 60 seconds;

Call abandonment less than 5%

Average calls answered within 11 seconds for MA

Abandonment Rate .74%

 

Average calls answered within 25 seconds for Marketplace.

Abandonment Rate for Marketplace 0.40%.

 

Average calls answered within 23 seconds for Commercial.

Abandonment Rate of 3.42% for Commercial

 

 

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