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

Recommendations

Info

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 127
128 N AT I o N A l C o M M I T T E E f o R Q U A l I T y A S S U R A N C E appropriate to each age group. Childhood vaccinations included in the composite are DTaP/ DT, hepatitis A, hepatitis b, HIb, IPV, MMR, pneumococcal conjugate and chicken pox vaccines, rotavirus, influenza and combinations. Adolescent vaccinations included in the composite are meningococcal, Tdap/Td and combinations. Consumer Experience is a summary of the following indicators: Getting Needed Care, Getting Care Quickly, How Well Doctors Communicate, Claims Processing, Customer Service, Rating of Personal Doctor, Rating of Specialist, Rating of All Health Care and Rating of Plan. All rating summaries reflect ratings of 9 or 10 and all composites correspond to responses of “Always.” The Diabetes composite summarizes the mean for the following indicators: blood Pressure Control (9%), lDl Cholesterol Screening, lDl Cholesterol Control (
Page 1 and 2:
Continuous Improvement and the Expa
Page 3 and 4:
2 This Report and the data containe
Page 5 and 6:
4 N AT I o N A l C o M M I T T E E
Page 7 and 8:
Page 9 and 10:
Page 11 and 12:
Page 13 and 14:
top 10 and bottom 10 states “loca
Page 15 and 16:
Page 17 and 18:
16 this measure has shown steady ga
Page 19 and 20:
Page 21 and 22:
Page 23 and 24:
Page 25 and 26:
24 HEDIS MEASURES of CARE about HEd
Page 27 and 28:
S A f E T y A N D P o T E N T I A l
Page 29 and 30:
Page 31 and 32:
Page 33 and 34:
Page 35 and 36:
Page 37 and 38:
W E l l N E S S A N D P R E V E N T
Page 39 and 40:
Page 41 and 42:
Page 43 and 44:
Page 45 and 46:
Page 47 and 48:
Page 49 and 50:
C H R o N I C D I S E A S E M A N A
Page 51 and 52:
Page 53 and 54:
Page 55 and 56:
Page 57 and 58:
Page 59 and 60:
Page 61 and 62:
Page 63 and 64:
Page 65 and 66:
Page 67 and 68:
Page 69 and 70:
Page 71 and 72:
Page 73 and 74:
M E A S U R E S T A R G E T E D A T
Page 75 and 76:
M E A S U R E S T A R G E T E D A T
Page 77 and 78: M E A S U R E S T A R G E T E D A T
Page 121 and 122: C o N S U M E R A N D P A T I E N T
Page 127: C o N S U M E R A N D P A T I E N T
Page 131 and 132: 130 APPENDIx 1: HEDIS EffECTIVENESS
Page 133 and 134: 132 N AT I o N A l C o M M I T T E
Page 135 and 136: 134 APPENDIx 2: HEDIS EffECTIVENESS
Page 143 and 144: 142 APPENDIx 4b: ACCREDITED VS. NoN
Page 149 and 150: 148 APPENDIx 6A: ACCREDITED VS. NoN
Page 151 and 152: 150 APPENDIx 6b: ACCREDITED VS. NoN
Page 153 and 154: 152 APPENDIx 7A: PUblICly REPoRTING
Page 159 and 160: 158 APPENDIx 8: PUblICly REPoRTING
Page 173 and 174: 172 MEASURE N AT I o N A l C o M M
Page 175 and 176: 174 APPENDIx 14b: VARIATIoN IN PlAN
Page 177 and 178: 176 MEASURE N AT I o N A l C o M M
Page 179 and 180:
178 MEASURE N AT I o N A l C o M M
Page 181 and 182:
180 APPENDIx 16A: VARIATIoN IN PlAN
Page 183 and 184:
182 APPENDIx 16b: VARIATIoN IN PlAN
Page 185 and 186:
184 REfERENCES N AT I o N A l C o M
Page 187 and 188:
186 N AT I o N A l C o M M I T T E
Page 189 and 190:
Page 191 and 192:
Page 193 and 194:
Page 195 and 196:
Page 197 and 198:
Page 200 and 201:
ACkNoWlEDGMENTS Health Plans The 20
show all

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

Create successful ePaper yourself

Delete template?

Save as template?