Continuous Improvement and the Expansion of Quality ... - NCQA

T H E S TAT E o f H E A l T H C A R E Q U A l I T y 2 0 1 1 • M E T H o D o l o G y o V E R V I E W
METHoDoloGy oVERVIEW
general Methods
Data in this report are from HEDIS year 2011, which is measure year 2010 (January 1–
December 31, 2010). Unless otherwise noted, all references to “years” in charts and tables are
to measure years, not HEDIS years.
because The State of Health Care Quality Report focuses on health plan performance, summary
tables are not weighted for the size of eligible populations. Most tables and appendices provide
mean rates separately for each measure, or for each indicator in a measure.
In most tables and appendices, rate means are provided side-by-side for commercial, Medicare
and Medicaid product lines. Results for HMo and PPo plans are shown in separate tables. HMo
plans include HMos, HMo/PoS combined, HMo/PPo/PoS combined, HMo/PPo combined
and PoS. only plans with the sole designation of PPo are shown as PPos in tables.
Some reporting periods are limited. for example, PPos have reported substantial HEDIS data
only since measure year 2005; Medicare and Medicaid performance data are reported only as
far back as measure year 2001.
best states
Identification of high-performing state cohorts is based on the state means of five measures:
Diabetes (nine indicators), Hypertension (one indicator), Persistence of Beta-Blockers After a
Heart Attack (one indicator) and Cholesterol Management for Patients With Cardiovascular
Conditions (two indicators).
The unweighted average of all indicators across all plans in a state is calculated for each state.
No distinction is made among plans with respect to product line or reporting type. The
composite means are ranked in descending order. The top 10 states compose the “best” cohort.
In the Diabetes quality composite, the Poor Glycemic Control Indicator is inverted before
calculating the composite so that higher performance is indicated by a higher rate.
Composite Measure Means by region
Analysis provides mean rates for several composite measures by U.S. Census region. The
Childhood and Adolescent Immunizations summary rate comprises the rates for vaccinations
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