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Mountain of Wellness
ADVANTAGE Health Solutions

Quality Improvement

HEDIS

What is HEDIS?

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.

HEDIS 2010 Measurement Guide
HEDIS 2011 Measurement Guide

CAHPS

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!

Our Rates NCQA Accredited
 
Measure/Data Element (with NCQA reported rate adjusted) 2010 RATES
 
Effectiveness of Care: Prevention and Screening
Adult BMI 37.12%
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
BMI percentile 17.17%
Counseling for Nutrition 42.47%
Counseling for Physical Activity 34.44%
Childhood Immunization Status (cis)
  Combination #2 71.91%
Immunization for Adolescents
  Menungococcal 48.80%
  Tdap/Td 51.47%
  Combination #1 42.96%
Breast Cancer Screening (bcs)
  Total 73.06%
Cervical Cancer Screening (ccs) 79.57%
Colorectal Cancer Screening (col) 63.39%
Chlamydia Screening in Women (chl)
  Total 45.10%
Effectiveness of Care: Respiratory Conditions
Appropriate Testing for Children with Pharyngitis (cwp) 74.12%
Appropriate Treatment for Children With URI (uri) 86.47%
*Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis (aab) 84.91%
Use of Spirometry Testing in the Assessment and Diagnosis of COPD (spr) 44.13%
Use of Appropriate Medications for People With Asthma (asm)
  Total 94.02%
Effectiveness of Care: Cardiovascular
Cholesterol Management for Patients With Cardiovascular Conditions (cmc)
  LDL-C Screening Performed 93.08%
  LDL-C Control (<100 mg/dL) 55.36%
Controlling High Blood Pressure (cbp) 61.20%
Persistence of Beta-Blocker Treatment After a Heart Attack (pbh) 85.23%
Effectiveness of Care: Diabetes
Comprehensive Diabetes Care (cdc)
  Hemoglobin A1c (HbA1c) Testing 92.83%
  HbA1c Poor Control (>9.0%) 51.23%
  Eye Exam (Retinal) Performed 41.98%
  LDL-C Screening Performed 86.27%
  LDL-C Control (<100 mg/dL) 40.77%
  Medical Attention for Nephropathy 91.37%
  Blood Pressure Control (<130/80 mm Hg) 29.09%
  Blood Pressure Control (<140/90 mm Hg) 58.77%
Effectiveness of Care: Musculoskeletal
Disease Modifying Anti-Rheumatic Drug therapy in Rheumatoid Arthritis (art) 93.21%
Use of Imaging Studies for Low Back Pain (lbp) 79.76%
Effectiveness of Care: Behavioral Health
Antidepressant Medication Management (amm)
  Effective Acute Phase Treatment 66.78%
  Effective Continuation Phase Treatment 51.07%
Follow-Up Care for Children Prescribed ADHD Medication (add)
  Initiation Phase 42.72%
  Continuation and Maintenance (C&M) Phase 39.62%
Follow-Up After Hospitalization for Mental Illness (fuh)
  30-Day Follow-Up 80.28%
  7-Day Follow-Up 61.93%
Effectiveness of Care: Medication Management
Annual Monitoring for Patients on Persistent Medications (mpm)
  ACE Inhibitors or ARBs 79.80%
  Digoxin 83.26%
  Diuretics 80.34%
  Anticonvulsants 82.29%
  Total 80.11%
Access/Availability of Care
Prenatal and Postpartum Care (ppc)
  Timeliness of Prenatal Care 81.64%
  Postpartum Care 80.43%
Call Answer Timeliness (cat) NR
Call Abandonment (cab) 4.52%
Use of Services
Well-Child Visits in the First 15 Months of Life (w15)
  6+ Visits 72.84%
Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life (w34) 64.01%
Adolescent Well-Care Visits (awc) 41.18%
Satisfaction with the Experience of Care
CAHPS Consumer Assessment of Health Providers and Systems Survey 4.0H, Adult
Getting Needed Care 87.10%
Getting Care Quickly 86.50%
How Well Doctors Communicate 93.50%
Customer Service 80.10%
Claims Processing 86.50%
Shared Decision Making 61.50%
Plan Information on cost 63.80%
Health Promotion & Education 63.90%
Coordination of Care 76.00%
Rating of Health Care 77.04%
Rating of Personal Doctor 82.37%
Rating of Specialist 80.39%
Rating of Health Plan 56.51%
Flu Shots for Adults Ages 50-64 (fsa) 57.50%
ASTQ (advised smokers to quit) 72.00%
Smoking Cessation- Medication 53.10%
Smoking Cessation- Strategies 40.40%
Asprin Use 39.60%
Discussing asprin risk and benefits 50.50%