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Quality Report Cards
HEDIS (performance measures developed by National Committee for Quality Assurance)
http://www.NCQA.org
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Quality Measure Description Rate Member Access and Use of Services Adults' Access to Preventative Health Services Adults who had ambulatory visits in the past three years: - Ages 20 to 44 - Ages 45 to 64 - Ages 65 and older
91% 92% 95% Children's Access to Primary Care Providers Children who had an ambulatory visit in 2003: - Ages 12 Months to24 Months - Ages 25 Months to 6 Years
Well-Child Visits in the First 15 Months of Life Children who had six or more well-child visits during the first 15 months on life. 57% Well-Child Visits in the Third Through Sixth Year of Life Children age three to six who had one or more well-child visits in 2003.
69% Well-Care Visits Adolescents age 12 to 21 who had one or more well-care visits in 2003. 36% Prevention and Childhood Immunizations Two-year-olds receiving the appropriate immunizations - One MMR between ages of one and two - Four DTP/DTaPs between ages of 42 days and two years - Three OPVs between ages of 42 days and two years - Three HIBs between ages 42 days and two years - Three Hep Bs by the age of two, with one falling on or between 6 months and two years. - One VZV between ages of 42 days and two years 90% 84% 87% 88% 80% 88% Adolescent Immunizations Adolescents who received the appropriate immunizations: - Two MMR's by age 13 - Three HepBs by age 13 - One VZV by age 13 70% Advising Smokers to Quit Represents the percentage of smokers who saw a doctor and were advised to quit smoking. NA Breast Cancer Screening Women ages 52 to 69 who had a mammogram during the previous two years. 71% Cervical Cancer Screening Women ages 21 to 64 who had a PAP test during the previous three years. 85% Maternity Care Prenatal Care Women who received prenatal care in the first trimester, or within 42 days of enrollment. 89% Postpartum Care Women who had a postpartum visit three to eight weeks after the delivery. Acute and Chronic Illness Beta-Blocker Treatment After a Heart Attack Adults who were prescribed a beta-blocker after hospitalization for a heart attack. 96% Eye Exams for People with Diabetes Diabetics age 18 to 75 who had an eye exam in 2003. 48% Follow-Up After Hospitalization for Mental Health Ambulatory follow-up witin 30 days of patients hospitalized for treatment of mental health disorder. 75% Cholesterol Management After Acute Cardivascular Events Member hospitalized for cardiovascular event who had a cholesterol screening. 73% Member Satisfaction How Would You Rate Your Health Plan? Represents the percentage of members who chose number 8-10 on the original scale of 0-10, where the 0 isthe lowest rating and 10 is the highest. NCQA considers 8-10 to be equivalent to ratings of "Completely 57% How Would You Rate Your Doctor or Nurse? Represents the percentage of members who chose number 8-10 on the original scale of 0-10, where the 0 is 72% How Would You Rate Your Specialist? Represents the percentage of members who chose number 8-10 on the original scale of 0-10, where the 0 is the lowest rating and 10 is the highest. NCQA considers 8-10 to be equivalent to ratings of "Completely Satisfied", "Very Satisfied", and "Somewhat Satisfied". 81%
Children who had an ambulatory visit in the past two years:
- Ages 7 to 11 years
- Ages 12 to 19 years
97%
89%
87%
82%
Screening
58%
50%
81%
Satisfied", "Very Satisfied", and "Somewhat Satisfied".
the lowest rating and 10 is the highest. NCQA considers 8-10 to be equivalent to ratings of "Completely
Satisfied", "Very Satisfied", and "Somewhat Satisfied".
HEDIS results (excl. survey data) are solely based upon recorded
and reported info. and therefore may understate actual performance.
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email: life@BRANCHINSURANCE.com
