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Michigan Quality Improvement Consortium Measurement Committee Year-End Report December 14, 2006. Information sharing among plans Health plan use of LOINC codes in lab data Administrative data Measures for new guidelines Adult preventive services (18-49 and 50 – 65+) Challenges - PowerPoint PPT Presentation
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Michigan Quality Improvement Consortium
Measurement Committee Year-End ReportDecember 14, 2006
Principal AccomplishmentsInformation sharing among plansHealth plan use of LOINC codes in lab dataAdministrative dataMeasures for new guidelinesAdult preventive services (18-49 and 50 65+)ChallengesVetted measure(s)Eligible populationPrevalenceExamplesHeart failure Deep Venous Thrombosis (DVT)
Principal AccomplishmentsUpdated MQIC measurement specificationsRemain current withHEDIS specificationsMQIC guidelinesMeasurement practices of participating health plansMQIC Measures Summary documentMeasurement Specification documentReporting and Trending PolicyImpact of rotated measures on trendingMQIC best practice
Principal AccomplishmentsAligned reporting with updated specifications and limitationsData Submission Tool for HEDIS measuresMQIC non-HEDIS data submission formWeb-based measurement resources (www.mqic.org/meas.htm)MQIC MeasuresMQIC Measurement SpecificationsMeasurement Committee Year-End ReportMQIC Lipid Lowering Agents
Principal AccomplishmentsEnhanced leadership links with Save Lives Save Dollars initiativeCollaborative opportunity on health plan reportingPotential for further alignment on matters of mutual interest, such as implementationPatient lists with integrated data
Analysis and Reporting
Product-specific, community-level results based on weighted data from reporting health plansNot simple average of plans as reported in Quality CompassTwo or more health plans had to provide current year data for an indicator to be included.Rotated measures: Included data as submitted in health plan Data Submission Tool (DST)Impact on year to year trendsDiabetes non-HEDIS measure blood pressure control not required to report (rotation)Opportunity to collaborate with MDCH on voluntary diabetes chart-based data collection
Analysis and Reporting
Data not availableCould not calculate annual quit rate, a non-HEDIS tobacco control measure (eliminated: recent quitters)Newly Reported in Quality Compass: % current smokers by health planNeed health plan data on # members 18+ for community rateSpecification changes impacting trending and reportingUse of appropriate medications for people with asthmaRedefined eligible populationSignificantly improved rateBreast cancer screening admin only measureCholesterol management for cardiovascular conditionsExpanded to include ischemic vascular conditionsMeasure not reported publicly by NCQA due to data / specifications
Analysis and Reporting
Product line reporting and trendingSpecifications differ by product lineContinuous enrollmentData availabilityAdministrative only vs. hybridBenefit designCovered benefits
Michigan Quality Improvement Consortium
Chart Book - 2006
MQIC Measurement CommitteeDecember, 2006
Chart1
0.53460.52330.56450.52540.50860.5490.6355
0.80330.84890.84120.8580.84450.88020.8876
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
diabetes non-hedis
Commercial
20042005
Lipid Lowering Rx51.12%63.53%
BP Control
MeasuresCY 2005 ResultsMQIC Best Practice
Prescription Filled for Lipid Lowering Drugs63.53%71.50%
Medicaid
2005
Lipid Lowering Rx91.65%
BP Control
MeasuresCY2005 ResultsMQIC Best Practice
Prescription Filled for Lipid Lowering Drugs91.65%99.47%
diabetes non-hedis
00
2004
2005
Measures
Percent
Non-HEDIS Diabetes IndicatorsCommercial MembersCalendar Years 2004 - 2005
diabetes hedis
0
2005
Measure
Percent
Non-HEDIS Diabetes IndicatorsMedicaid MembersCalendar Year 2005
asthma non-hedis
CommercialMedicaidMedicare
200020012002200320042005200620002001200220032004200520062006
Retinal Exams53.46%52.33%56.45%52.54%50.86%54.90%63.55%Retinal Exams43.11%53.51%50.80%41.31%43.61%49.90%55.35%Retinal Exams80.50%
Glyc Hb Testing80.33%84.89%84.12%85.80%84.45%88.02%88.76%Glyc Hb Testing69.33%73.59%75.56%74.73%73.48%81.43%80.05%Glyc Hb Testing93.04%
Glyc HB Poor Control18.02%
20002001200220032004200520062000200120022003200420052006LDL-C Control < 13080.33%
Glyc Hb Poor Control31.19%39.02%28.82%31.64%29.97%27.14%27.65%Glyc Hb Poor Control37.41%46.48%43.16%57.47%52.24%42.70%42.28%LDL-C Control < 10054.37%
LDL-C Testing65.82%76.78%82.92%87.38%89.27%93.32%93.73%LDL-C Testing54.60%63.53%68.49%72.77%72.99%83.54%83.54%Nephropathy Monitoring76.19%
20002001200220032004200520062000200120022003200420052006
LDL-C Control < 13039.25%48.24%56.94%57.58%65.41%71.24%73.04%LDL-C Control < 13027.07%35.79%41.34%41.18%50.79%61.88%63.76%
LDL-C Control < 10037.85%43.08%47.52%LDL-C Control < 10034.11%44.90%46.07%
20002001200220032004200520062000200120022003200420052006
Nephropathy Monitoring42.65%43.73%57.99%62.37%51.77%54.62%61.21%Nephropathy Monitoring45.26%47.62%53.35%54.28%41.02%49.88%53.45%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Retinal Exams66.50%83.78%
Glycosylated Hemoglobin Testing88.90%95.09%
Glycosylated Hemoglobin Poor Control23.60%9.58%
LDL-C Testing93.30%97.81%
LDL-C Control < 130 mg/dL71.60%80.54%
LDL-C Control < 100 mg/dL50.00%54.74%
Nephropathy Monitoring60.20%81.06%
MeasuresHEDIS 2006 ResultsMQIC Best PracticeMeasuresHEDIS 2006 ResultsMQIC Best Practice
Retinal Exams54.80%67.88%Retinal Exams48.60%70.32%
Glycosylated Hemoglobin Testing87.50%91.73%Glycosylated Hemoglobin Testing76.20%88.78%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
MeasuresHEDIS 2006 ResultsMQIC Best PracticeGlycosylated Hemoglobin Poor Control49.10%29.68%
Glycosylated Hemoglobin Poor Control29.70%19.95%LDL-C Testing80.50%91.56%
LDL-C Testing92.30%96.59%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
MeasuresHEDIS 2006 ResultsMQIC Best PracticeLDL-C Control < 130 mg/dL51.30%72.26%
LDL-C Control < 130 mg/dL67.50%81.51%LDL-C Control < 100 mg/dL32.60%62.04%
LDL-C Control < 100 mg/dL43.80%54.26%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Nephropathy Monitoring48.80%65.92%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Nephropathy Monitoring55.10%73.35%
asthma non-hedis
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
asthma-hedis
0
0
0
0
0
0
2006
Measures
Percent
HEDIS Diabetes IndicatorsMedicare MembersHEDIS 2006
depression hedis
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Commercial Members HEDIS 2001 - HEDIS 2006
tobacco control non-hedis
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
tobacco control hedis
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
bcbsm diab hedis
0000000
0000000
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Medicaid Members HEDIS 2001 - HEDIS 2006
bcbsm diab non-hedis
0000000
0000000
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Medicaid Members HEDIS 2001 - HEDIS 2006
bcbsm asthma hedis
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Medicaid Members HEDIS 2001 - HEDIS 2006
bcbsm asthma non-hedis
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Medicaid Members HEDIS 2001 - HEDIS 2006
bcbsm tobacco control hedis
Commercial
20012002200320042005
Asthma ER Rate/100076.09115.0262.60131.7897.33
Asthma Px Exams (%)73.6185.9981.8688.1090.66
MeasuresCY 2005 ResultsMQIC Best Practice
Emergency Room Visits for Asthma/1000 Members with Asthma97.3346.76
Periodic Assessment for Asthma90.66%93.69%
Medicaid
2005
Asthma ER Rate/1000160.31
Asthma Px Exams (%)71.35
MeasuresCY 2005 ResultsMQIC Best Practice
Emergency Room Visits for Asthma/1000 Members with Asthma160.3196.88
Periodic Assessment for Asthma71.35%96.55%
bcbsm tobacco control hedis
00000
00000
2001
2002
2003
2004
2005
Measures
Rate
Non-HEDIS Asthma IndicatorsCommercial MembersCalendar Years 2001 - 2005
bcbsm pharyngitis
0
0
2005
Measures
Rate
Non-HEDIS Asthma Indicators Medicaid Members Calendar Year 2005
bcbsm adultprev hedis
Commercial
20002001200220032004
asthma med 5-9 yo65.51%64.49%69.49%63.45%73.57%94.63%
asthma med 10-17 yo64.53%65.35%64.44%58.06%66.80%91.49%
20002001200220032004
asthma med 18-56 yo68.69%67.09%69.84%65.55%72.19%90.27%
asthma med all67.60%66.45%68.75%63.69%71.31%91.13%
Medicaid
20002001200220032004
asthma med 5-9 yo65.22%60.76%61.48%51.11%64.39%87.56%
asthma med 10-17 yo56.04%63.61%64.42%58.98%63.82%86.47%
20002001200220032004
asthma med 18-56 yo62.89%63.43%70.39%68.23%70.03%85.58%
asthma med all61.97%62.90%66.90%62.09%67.07%86.21%
*2005 - Specification Change*2005 - Specification Change
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Appropriate Asthma Medications 5 - 9 Years Old95.70%99.39%
Appropriate Asthma Medications 10 - 17 Years Old91.70%98.15%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Appropriate Asthma Medications 5 - 9 Years Old88.00%94.59%
Appropriate Asthma Medications 10 - 17 Years Old85.60%92.26%
*2005 - Specification Change*2005 - Specification Change
MeasuresHEDIS 2006 ResultsMQIC Best Practice
MeasuresHEDIS 2006 ResultsMQIC Best PracticeAppropriate Asthma Medications 18 - 56 Years Old83.40%91.18%
Appropriate Asthma Medications 18 - 56 Years Old88.50%94.59%Appropriate Asthma Medications Combined Ages85.70%92.18%
Appropriate Asthma Medications Combined Ages89.90%95.91%
bcbsm adultprev hedis
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
pharyngitis
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsMedicaid MembersHEDIS 2001 - HEDIS 2006
hypertension non-hedis
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
hypertension
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsMedicaid MembersHEDIS 2001 - HEDIS 2006
bcbs hyperlipidemia
CommercialMedicare
20022003200420052005
Anti-Dep Med Opt Contact18.91%25.00%25.76%25.72%Anti-Dep Med Opt Contact13.61%
Anti-Dep Med Acute Tx54.92%60.67%56.10%56.94%Anti-Dep Med Acute Tx47.62%
Anti-Dep Med Cont Tx38.01%41.58%38.43%40.07%Anti-Dep Med Cont Tx31.97%
MeasureHEDIS 2006 ResultsMQIC Best Practice
Antidepressant Medications, Optimal Contacts11.80%13.71%
Antidepressant Medications, Effective Acute54.90%47.83%
Treatment Phase
Antidepressant Medication, Effective Continu-41.00%39.13%
ation Treatment Phase
MeasureHEDIS 2006 ResultsMQIC Best Practice
Antidepressant Medications, Optimal Contacts20.60%28.91%
Antidepressant Medications, Effective Acute61.40%63.55%
Treatment Phase
Antidepressant Medication, Effective Continu-45.00%48.19%
ation Treatment Phase
bcbs hyperlipidemia
0000
0000
0000
2002
2003
2004
2005
Measures
Percent
HEDIS Depression IndicatorsCommercial MembersHEDIS 2003 - HEDIS 2006
hyperlipidemia
0
0
0
2005
Measures
Percentage
HEDIS Depression Indicators Medicare Members HEDIS 2006
aaod
Commercial
200320042005
Smoking Prevalence19.67%21.27%15.14%
Quit Rate10.09%10.56%
MeasuresCY 2005 ResultsMQIC Best Practice
Smoking Prevalence15.14%11.87%
Medicaid
20042005
Smoking Prevalence42.28%39.64%
Quit Rate3.51%
MeasuresCalendar Year 2005 ResultsMQIC Best Practice
Smoking Prevalence39.64%37.96%
aaod
000
2003
2004
2005
Measures
Percent
Non-HEDIS Tobacco Control IndicatorsCommercial MembersCalendar Years 2004 - 2005
Sheet3
00
2004
2005
Measures
Percent
Non-HEDIS Tobacco Control IndicatorsMedicaid MembersCalendar Years 2004 - 2005
Sheet2
commercial
200320042005
Adv Smokers to Quit74.90%74.73%69.28%
Disc Smok Cess Meds47.86%46.33%38.55%
Disc Smok Cess Strat41.96%40.57%35.76%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Advising Smokers to Quit71.20%83.33%
Discussion of Smoking Cessation Medications39.40%48.82%
Discussion of Smoking Cessation Strategies39.00%50.16%
Medicaid
20042005
Adv Smokers to Quit67.64%76.60%
Disc Smok Cess Meds38.20%66.42%
Disc Smok Cess Strat32.70%66.79%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Advising Smokers to Quit65.60%75.85%
Discussion of Smoking Cessation Medications31.90%44.68%
Discussion of Smoking Cessation Strategies34.10%50.16%
Sheet2
000
000
000
2003
2004
2005
Measures
Percent
HEDIS Tobacco Control IndicatorsCommercial MembersHEDIS 2004 - HEDIS 2006
adultprev hedis
00
00
00
2004
2005
Measures
Percent
HEDIS Tobacco Control IndicatorsMedicaid MembersHEDIS 2005 - HEDIS 2006
200020012002200320042005
Retinal Exams44.42%43.54%44.80%39.98%32.04%
Glyc Hb Testing68.29%68.28%69.28%77.83%74.79%80.14%
LDL-C Testing71.70%75.54%79.69%82.56%83.56%87.11%
Nephropathy Monitoring22.30%23.03%26.58%32.29%30.04%38.73%
000000
000000
000000
000000
2000
2001
2002
2003
2004
2005
Measures
Percent
HEDIS Diabetes IndicatorsBCBSM MembersHEDIS 2001 - HEDIS 2006
2005
Lipid Lowering Rx63.87%
0
2005
Measures
Percent
Non-HEDIS Diabetes Indicators BCBSM Members Calendar Year 2005
20002001200220032004
asthma med 5-9 yo67.94%69.63%72.16%75.07%76.29%96.89%
asthma med 10-17 yo62.36%64.51%66.40%69.50%70.26%93.74%
20002001200220032004
asthma med 18-56 yo67.55%68.37%72.50%73.30%72.91%90.44%
asthma med all66.62%67.74%71.42%72.81%72.77%91.72%
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsBCBSM MembersHEDIS 2001 - HEDIS 2006
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsBCBS MembersHEDIS 2001 - HEDIS 2006
20012002200320042005
Asthma ER Rate/100052.1957.5452.5749.7844.19
Asthma Px Exams (%)73.2075.8875.9476.3076.09
00000
00000
2001
2002
2003
2004
2005
Measures
Rate
Non-HEDIS Asthma IndicatorsBCBSM MembersCalendar Years 2001-2005
2005
Adv Smokers to Quit72.51%
Disc Smok Cess Meds44.02%
Disc Smok Cess Strat43.41%
0
0
0
2005
Measures
Percent
HEDIS Tobacco Control Indicators BCBSM Members HEDIS 2006
% 2-18 yo tested
20042005
2-18 Years Old Tested54.58%54.17%
00
2004
2005
HEDIS AC Pharyngitis IndicatorsBCBSM MembersHEDIS 2005 - HEDIS 2006
2005
cxcascrg 21-64 yrs74.71%
brcascrg 52-69 yrs71.32%
0
0
2005
Measures
Percent
Adult Preventive Services Indicators BCBSM Members HEDIS 2006 - Baseline
% 2-18 yo tested
20042005
Commercial69.81%63.32%
Medicaid26.60%34.82%
Percent 2 - 18 Years Old Tested for Strept and Were Prescribed an Antibiotic
ProductHEDIS 2006 ResultsMQIC Best Practice
Commercial69.70%74.00%
Medicaid52.00%58.78%
00
00
2004
2005
Product
Percent
HEDIS AC Pharyngitis IndicatorsHEDIS 2005 - HEDIS 2006
Dx HTN
2005
Commercial18.81%
Medicaid11.78%
Medicare71.70%
ProductCY 2005 ResultsMQIC Best Practice
Commercial18.81%12.03%
Medicaid11.78%19.43%
Medicare71.70%69.44%
0
0
0
2005
Product
Percent
Non-HEDIS Hypertension IndicatorPercent Members with any Diagnosis of HypertensionCalendar Year 2005 - Baseline
CBP
20042005
Comm65.86%75.23%
Medicaid57.87%59.23%
Medicare71.70%
ProductHEDIS 2006 ResultsMQIC Best Practice
Commercial68.80%76.86%
Medicaid61.40%75.96%
Medicare66.40%72.26%
00
00
00
2004
2005
Product
Percent
HEDIS Hypertension Indicators - CBP HEDIS 2005 - HEDIS 2006
20042005
CDC LDL-C Testing83.36%
CHM LDL-C Testing74.63%
0
0
2004
Measures
Percent
Hyperlipidemia HEDIS IndicatorsBCBS MembersHEDIS 2005 - HEDIS 2006
comm
20042005
CDC LDL test89.27%
CDC LDL < 130 mg/dL65.41%
CDC LDL < 100 mg/dL37.85%
CHM test78.01%
CHM < 130 mg/dL63.29%
CHM < 100 mg/dL47.35%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
CDC LDL test
CDC LDL < 130 mg/dL
CDC LDL < 100 mg/dL
CHM test
CHM < 130 mg/dL
CHM < 130 mg/dL
Medicaid
20042005
CDC LDL test72.99%
CDC LDL < 130 mg/dL50.79%
CDC LDL < 100 mg/dL34.11%
CHM test57.71%
CHM < 130 mg/dL40.57%
CHM < 100 mg/dL26.86%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
CDC LDL test
CDC LDL < 130 mg/dL
CDC LDL < 100 mg/dL
CHM test
CHM < 130 mg/dL
CHM < 130 mg/dL
0
0
0
0
0
0
2004
Measures
Percent
Hyperlipidemia HEDIS IndicatorsCommercial MembersHEDIS 2005 - HEDIS 2006
0
0
0
0
0
0
2004
Measures
Percent
Hyperlipidemia HEDIS IndicatorsMedicaid MembersHEDIS 2005 - HEDIS 2006
commMedicare
200420052005
Initiation of AAOD Tx55.07%49.52%Initiation of AAOD Tx68.39%
Engagement of AAOD Tx25.10%21.31%Engagement of AAOD Tx5.81%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Initiation of Alcohol & Other Drug Dependence
Treatment50.90%83.33%
Engagement of Alcohol & Other Drug Dependence Treatment4.70%8.33%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Initiation of Alcohol & Other Drug Dependence Treatment44.50%55.65%
Engagement of Alcohol & Other Drug Dependence Treatment14.10%25.00%
00
00
2004
2005
Measures
Percent
Substance Use Disorders HEDIS IndicatorsCommercial MembersHEDIS 2005 - HEDIS 2006
0
0
2005
Measures
Percentage
Substance Use Disorders HEDIS Indicators Medicare Members HEDIS 2006
Commercial
2005
chlamscrg 16-25 yrs39.20%
colcascrg 51-80 yrs58.68%
cxcascrg 21-64 yrs86.59%
brcascrg 52-69 yrs77.82%
Medicaid
2005
chlamscrg 16-25 yrs54.67%
cxcascrg 21-64 yrs64.21%
brcascrg 52-69 yrs57.11%
Medicare
2005
colcascrg 51-80 yrs64.33%
brcascrg 52-69 yrs80.09%
MeasuresHEDIS 2006 ResultsMQIC Best PracticeMeasuresHEDIS 2006 ResultsMQIC Best Practice
Chlamydia Screening Combined16-25 yrs34.90%48.30%Chlamydia Screening Combined16-25 yrs50.60%64.30%
Colorectal Cancer Screening52.30%69.34%Cervical Cancer Screening65.00%74.45%
Cervical Cancer Screening81.80%88.60%Breast Cancer Screening53.90%61.77%
Breast Cancer Screening72.00%82.22%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Colorectal Cancer Screening53.90%69.81%
Breast Cancer Screening71.60%85.97%
0
0
0
2005
Measures
Percent
Adult Preventive Services Indicators Medicaid Members HEDIS 2006 - Baseline
0
0
0
0
2005
Measures
Percent
Adult Preventive Services Indicators Commerical Members HEDIS 2006 - Baseline
0
0
2005
Measures
Percent
Adult Preventive Services Indicators Medicare Members HEDIS 2006 - Baseline
diabetes non-hedis
Commercial
20042005
Lipid Lowering Rx51.12%63.53%
BP Control
MeasuresCY 2005 ResultsMQIC Best Practice
Prescription Filled for Lipid Lowering Drugs63.53%71.50%
Medicaid
2005
Lipid Lowering Rx91.65%
BP Control
MeasuresCY2005 ResultsMQIC Best Practice
Prescription Filled for Lipid Lowering Drugs91.65%99.47%
diabetes non-hedis
00
2004
2005
Measures
Percent
Non-HEDIS Diabetes IndicatorsCommercial MembersCalendar Years 2004 - 2005
diabetes hedis
0
2005
Measure
Percent
Non-HEDIS Diabetes IndicatorsMedicaid MembersCalendar Year 2005
asthma non-hedis
CommercialMedicaidMedicare
200020012002200320042005200620002001200220032004200520062006
Retinal Exams53.46%52.33%56.45%52.54%50.86%54.90%63.55%Retinal Exams43.11%53.51%50.80%41.31%43.61%49.90%55.35%Retinal Exams80.50%
Glyc Hb Testing80.33%84.89%84.12%85.80%84.45%88.02%88.76%Glyc Hb Testing69.33%73.59%75.56%74.73%73.48%81.43%80.05%Glyc Hb Testing93.04%
Glyc HB Poor Control18.02%
20002001200220032004200520062000200120022003200420052006LDL-C Control < 13080.33%
Glyc Hb Poor Control31.19%39.02%28.82%31.64%29.97%27.14%27.65%Glyc Hb Poor Control37.41%46.48%43.16%57.47%52.24%42.70%42.28%LDL-C Control < 10054.37%
LDL-C Testing65.82%76.78%82.92%87.38%89.27%93.32%93.73%LDL-C Testing54.60%63.53%68.49%72.77%72.99%83.54%83.54%Nephropathy Monitoring76.19%
20002001200220032004200520062000200120022003200420052006
LDL-C Control < 13039.25%48.24%56.94%57.58%65.41%71.24%73.04%LDL-C Control < 13027.07%35.79%41.34%41.18%50.79%61.88%63.76%
LDL-C Control < 10037.85%43.08%47.52%LDL-C Control < 10034.11%44.90%46.07%
20002001200220032004200520062000200120022003200420052006
Nephropathy Monitoring42.65%43.73%57.99%62.37%51.77%54.62%61.21%Nephropathy Monitoring45.26%47.62%53.35%54.28%41.02%49.88%53.45%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Retinal Exams66.50%83.78%
Glycosylated Hemoglobin Testing88.90%95.09%
Glycosylated Hemoglobin Poor Control23.60%9.58%
LDL-C Testing93.30%97.81%
LDL-C Control < 130 mg/dL71.60%80.54%
LDL-C Control < 100 mg/dL50.00%54.74%
Nephropathy Monitoring60.20%81.06%
MeasuresHEDIS 2006 ResultsMQIC Best PracticeMeasuresHEDIS 2006 ResultsMQIC Best Practice
Retinal Exams54.80%67.88%Retinal Exams48.60%70.32%
Glycosylated Hemoglobin Testing87.50%91.73%Glycosylated Hemoglobin Testing76.20%88.78%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
MeasuresHEDIS 2006 ResultsMQIC Best PracticeGlycosylated Hemoglobin Poor Control49.10%29.68%
Glycosylated Hemoglobin Poor Control29.70%19.95%LDL-C Testing80.50%91.56%
LDL-C Testing92.30%96.59%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
MeasuresHEDIS 2006 ResultsMQIC Best PracticeLDL-C Control < 130 mg/dL51.30%72.26%
LDL-C Control < 130 mg/dL67.50%81.51%LDL-C Control < 100 mg/dL32.60%62.04%
LDL-C Control < 100 mg/dL43.80%54.26%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Nephropathy Monitoring48.80%65.92%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Nephropathy Monitoring55.10%73.35%
asthma non-hedis
0000000
0000000
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
asthma-hedis
0
0
0
0
0
0
2006
Measures
Percent
HEDIS Diabetes IndicatorsMedicare MembersHEDIS 2006
depression hedis
0000000
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Commercial Members HEDIS 2001 - HEDIS 2006
tobacco control non-hedis
0000000
0000000
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
tobacco control hedis
0000000
0000000
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
bcbsm diab hedis
0000000
0000000
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Medicaid Members HEDIS 2001 - HEDIS 2006
bcbsm diab non-hedis
0000000
0000000
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Medicaid Members HEDIS 2001 - HEDIS 2006
bcbsm asthma hedis
0000000
0000000
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Medicaid Members HEDIS 2001 - HEDIS 2006
bcbsm asthma non-hedis
0000000
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Medicaid Members HEDIS 2001 - HEDIS 2006
bcbsm tobacco control hedis
Commercial
20012002200320042005
Asthma ER Rate/100076.09115.0262.60131.7897.33
Asthma Px Exams (%)73.6185.9981.8688.1090.66
MeasuresCY 2005 ResultsMQIC Best Practice
Emergency Room Visits for Asthma/1000 Members with Asthma97.3346.76
Periodic Assessment for Asthma90.66%93.69%
Medicaid
2005
Asthma ER Rate/1000160.31
Asthma Px Exams (%)71.35
MeasuresCY 2005 ResultsMQIC Best Practice
Emergency Room Visits for Asthma/1000 Members with Asthma160.3196.88
Periodic Assessment for Asthma71.35%96.55%
bcbsm tobacco control hedis
00000
00000
2001
2002
2003
2004
2005
Measures
Rate
Non-HEDIS Asthma IndicatorsCommercial MembersCalendar Years 2001 - 2005
bcbsm pharyngitis
0
0
2005
Measures
Rate
Non-HEDIS Asthma Indicators Medicaid Members Calendar Year 2005
bcbsm adultprev hedis
Commercial
20002001200220032004*2005
asthma med 5-9 yo65.51%64.49%69.49%63.45%73.57%94.63%
asthma med 10-17 yo64.53%65.35%64.44%58.06%66.80%91.49%
20002001200220032004*2005
asthma med 18-56 yo68.69%67.09%69.84%65.55%72.19%90.27%
asthma med all67.60%66.45%68.75%63.69%71.31%91.13%
Medicaid
20002001200220032004*2005
asthma med 5-9 yo65.22%60.76%61.48%51.11%64.39%87.56%
asthma med 10-17 yo56.04%63.61%64.42%58.98%63.82%86.47%
20002001200220032004*2005
asthma med 18-56 yo62.89%63.43%70.39%68.23%70.03%85.58%
asthma med all61.97%62.90%66.90%62.09%67.07%86.21%
*2005 - Specification Change*2005 - Specification Change
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Appropriate Asthma Medications 5 - 9 Years Old95.70%99.39%
Appropriate Asthma Medications 10 - 17 Years Old91.70%98.15%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Appropriate Asthma Medications 5 - 9 Years Old88.00%94.59%
Appropriate Asthma Medications 10 - 17 Years Old85.60%92.26%
*2005 - Specification Change*2005 - Specification Change
MeasuresHEDIS 2006 ResultsMQIC Best Practice
MeasuresHEDIS 2006 ResultsMQIC Best PracticeAppropriate Asthma Medications 18 - 56 Years Old83.40%91.18%
Appropriate Asthma Medications 18 - 56 Years Old88.50%94.59%Appropriate Asthma Medications Combined Ages85.70%92.18%
Appropriate Asthma Medications Combined Ages89.90%95.91%
bcbsm adultprev hedis
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
pharyngitis
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsMedicaid MembersHEDIS 2001 - HEDIS 2006
hypertension non-hedis
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
hypertension
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsMedicaid MembersHEDIS 2001 - HEDIS 2006
bcbs hyperlipidemia
CommercialMedicare
20022003200420052005
Anti-Dep Med Opt Contact18.91%25.00%25.76%25.72%Anti-Dep Med Opt Contact13.61%
Anti-Dep Med Acute Tx54.92%60.67%56.10%56.94%Anti-Dep Med Acute Tx47.62%
Anti-Dep Med Cont Tx38.01%41.58%38.43%40.07%Anti-Dep Med Cont Tx31.97%
MeasureHEDIS 2006 ResultsMQIC Best Practice
Antidepressant Medications, Optimal Contacts11.80%13.71%
Antidepressant Medications, Effective Acute54.90%47.83%
Treatment Phase
Antidepressant Medication, Effective Continu-41.00%39.13%
ation Treatment Phase
MeasureHEDIS 2006 ResultsMQIC Best Practice
Antidepressant Medications, Optimal Contacts20.60%28.91%
Antidepressant Medications, Effective Acute61.40%63.55%
Treatment Phase
Antidepressant Medication, Effective Continu-45.00%48.19%
ation Treatment Phase
bcbs hyperlipidemia
0000
0000
0000
2002
2003
2004
2005
Measures
Percent
HEDIS Depression IndicatorsCommercial MembersHEDIS 2003 - HEDIS 2006
hyperlipidemia
0
0
0
2005
Measures
Percentage
HEDIS Depression Indicators Medicare Members HEDIS 2006
aaod
Commercial
200320042005
Smoking Prevalence19.67%21.27%15.14%
Quit Rate10.09%10.56%
MeasuresCY 2005 ResultsMQIC Best Practice
Smoking Prevalence15.14%11.87%
Medicaid
20042005
Smoking Prevalence42.28%39.64%
Quit Rate3.51%
MeasuresCalendar Year 2005 ResultsMQIC Best Practice
Smoking Prevalence39.64%37.96%
aaod
000
2003
2004
2005
Measures
Percent
Non-HEDIS Tobacco Control IndicatorsCommercial MembersCalendar Years 2004 - 2005
Sheet3
00
2004
2005
Measures
Percent
Non-HEDIS Tobacco Control IndicatorsMedicaid MembersCalendar Years 2004 - 2005
Sheet2
commercial
200320042005
Adv Smokers to Quit74.90%74.73%69.28%
Disc Smok Cess Meds47.86%46.33%38.55%
Disc Smok Cess Strat41.96%40.57%35.76%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Advising Smokers to Quit71.20%83.33%
Discussion of Smoking Cessation Medications39.40%48.82%
Discussion of Smoking Cessation Strategies39.00%50.16%
Medicaid
20042005
Adv Smokers to Quit67.64%76.60%
Disc Smok Cess Meds38.20%66.42%
Disc Smok Cess Strat32.70%66.79%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Advising Smokers to Quit65.60%75.85%
Discussion of Smoking Cessation Medications31.90%44.68%
Discussion of Smoking Cessation Strategies34.10%50.16%
Sheet2
000
000
000
2003
2004
2005
Measures
Percent
HEDIS Tobacco Control IndicatorsCommercial MembersHEDIS 2004 - HEDIS 2006
adultprev hedis
00
00
00
2004
2005
Measures
Percent
HEDIS Tobacco Control IndicatorsMedicaid MembersHEDIS 2005 - HEDIS 2006
200020012002200320042005
Retinal Exams44.42%43.54%44.80%39.98%32.04%
Glyc Hb Testing68.29%68.28%69.28%77.83%74.79%80.14%
LDL-C Testing71.70%75.54%79.69%82.56%83.56%87.11%
Nephropathy Monitoring22.30%23.03%26.58%32.29%30.04%38.73%
000000
000000
000000
000000
2000
2001
2002
2003
2004
2005
Measures
Percent
HEDIS Diabetes IndicatorsBCBSM MembersHEDIS 2001 - HEDIS 2006
2005
Lipid Lowering Rx63.87%
0
2005
Measures
Percent
Non-HEDIS Diabetes Indicators BCBSM Members Calendar Year 2005
20002001200220032004*2005
asthma med 5-9 yo67.94%69.63%72.16%75.07%76.29%96.89%
asthma med 10-17 yo62.36%64.51%66.40%69.50%70.26%93.74%
20002001200220032004*2005
asthma med 18-56 yo67.55%68.37%72.50%73.30%72.91%90.44%
asthma med all66.62%67.74%71.42%72.81%72.77%91.72%
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsBCBSM MembersHEDIS 2001 - HEDIS 2006
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsBCBS MembersHEDIS 2001 - HEDIS 2006
20012002200320042005
Asthma ER Rate/100052.1957.5452.5749.7844.19
Asthma Px Exams (%)73.2075.8875.9476.3076.09
00000
00000
2001
2002
2003
2004
2005
Measures
Rate
Non-HEDIS Asthma IndicatorsBCBSM MembersCalendar Years 2001-2005
2005
Adv Smokers to Quit72.51%
Disc Smok Cess Meds44.02%
Disc Smok Cess Strat43.41%
0
0
0
2005
Measures
Percent
HEDIS Tobacco Control Indicators BCBSM Members HEDIS 2006
% 2-18 yo tested
20042005
2-18 Years Old Tested54.58%54.17%
00
2004
2005
HEDIS AC Pharyngitis IndicatorsBCBSM MembersHEDIS 2005 - HEDIS 2006
2005
cxcascrg 21-64 yrs74.71%
brcascrg 52-69 yrs71.32%
0
0
2005
Measures
Percent
Adult Preventive Services Indicators BCBSM Members HEDIS 2006 - Baseline
% 2-18 yo tested
20042005
Commercial69.81%63.32%
Medicaid26.60%34.82%
Percent 2 - 18 Years Old Tested for Strept and Were Prescribed an Antibiotic
ProductHEDIS 2006 ResultsMQIC Best Practice
Commercial69.70%74.00%
Medicaid52.00%58.78%
00
00
2004
2005
Product
Percent
HEDIS AC Pharyngitis IndicatorsHEDIS 2005 - HEDIS 2006
Dx HTN
2005
Commercial18.81%
Medicaid11.78%
Medicare71.70%
ProductCY 2005 ResultsMQIC Best Practice
Commercial18.81%12.03%
Medicaid11.78%19.43%
Medicare71.70%69.44%
0
0
0
2005
Product
Percent
Non-HEDIS Hypertension IndicatorPercent Members with any Diagnosis of HypertensionCalendar Year 2005 - Baseline
CBP
20042005
Comm65.86%75.23%
Medicaid57.87%59.23%
Medicare71.70%
ProductHEDIS 2006 ResultsMQIC Best Practice
Commercial68.80%76.86%
Medicaid61.40%75.96%
Medicare66.40%72.26%
00
00
00
2004
2005
Product
Percent
HEDIS Hypertension Indicators - CBP HEDIS 2005 - HEDIS 2006
20042005
CDC LDL-C Testing83.36%
CHM LDL-C Testing74.63%
0
0
2004
Measures
Percent
Hyperlipidemia HEDIS IndicatorsBCBS MembersHEDIS 2005 - HEDIS 2006
comm
20042005
CDC LDL test89.27%
CDC LDL < 130 mg/dL65.41%
CDC LDL < 100 mg/dL37.85%
CHM test78.01%
CHM < 130 mg/dL63.29%
CHM < 100 mg/dL47.35%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
CDC LDL test
CDC LDL < 130 mg/dL
CDC LDL < 100 mg/dL
CHM test
CHM < 130 mg/dL
CHM < 130 mg/dL
Medicaid
20042005
CDC LDL test72.99%
CDC LDL < 130 mg/dL50.79%
CDC LDL < 100 mg/dL34.11%
CHM test57.71%
CHM < 130 mg/dL40.57%
CHM < 100 mg/dL26.86%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
CDC LDL test
CDC LDL < 130 mg/dL
CDC LDL < 100 mg/dL
CHM test
CHM < 130 mg/dL
CHM < 130 mg/dL
0
0
0
0
0
0
2004
Measures
Percent
Hyperlipidemia HEDIS IndicatorsCommercial MembersHEDIS 2005 - HEDIS 2006
0
0
0
0
0
0
2004
Measures
Percent
Hyperlipidemia HEDIS IndicatorsMedicaid MembersHEDIS 2005 - HEDIS 2006
commMedicare
200420052005
Initiation of AAOD Tx55.07%49.52%Initiation of AAOD Tx68.39%
Engagement of AAOD Tx25.10%21.31%Engagement of AAOD Tx5.81%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Initiation of Alcohol & Other Drug Dependence
Treatment50.90%83.33%
Engagement of Alcohol & Other Drug Dependence Treatment4.70%8.33%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Initiation of Alcohol & Other Drug Dependence Treatment44.50%55.65%
Engagement of Alcohol & Other Drug Dependence Treatment14.10%25.00%
00
00
2004
2005
Measures
Percent
Substance Use Disorders HEDIS IndicatorsCommercial MembersHEDIS 2005 - HEDIS 2006
0
0
2005
Measures
Percentage
Substance Use Disorders HEDIS Indicators Medicare Members HEDIS 2006
Commercial
2005
chlamscrg 16-25 yrs39.20%
colcascrg 51-80 yrs58.68%
cxcascrg 21-64 yrs86.59%
brcascrg 52-69 yrs77.82%
Medicaid
2005
chlamscrg 16-25 yrs54.67%
cxcascrg 21-64 yrs64.21%
brcascrg 52-69 yrs57.11%
Medicare
2005
colcascrg 51-80 yrs64.33%
brcascrg 52-69 yrs80.09%
MeasuresHEDIS 2006 ResultsMQIC Best PracticeMeasuresHEDIS 2006 ResultsMQIC Best Practice
Chlamydia Screening Combined16-25 yrs34.90%48.30%Chlamydia Screening Combined16-25 yrs50.60%64.30%
Colorectal Cancer Screening52.30%69.34%Cervical Cancer Screening65.00%74.45%
Cervical Cancer Screening81.80%88.60%Breast Cancer Screening53.90%61.77%
Breast Cancer Screening72.00%82.22%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Colorectal Cancer Screening53.90%69.81%
Breast Cancer Screening71.60%85.97%
0
0
0
2005
Measures
Percent
Adult Preventive Services Indicators Medicaid Members HEDIS 2006 - Baseline
0
0
0
0
2005
Measures
Percent
Adult Preventive Services Indicators Commerical Members HEDIS 2006 - Baseline
0
0
2005
Measures
Percent
Adult Preventive Services Indicators Medicare Members HEDIS 2006 - Baseline
Chart2
0.31190.39020.28820.31640.29970.27140.2765
0.65820.76780.82920.87380.89270.93320.9373
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
diabetes non-hedis
Commercial
20042005
Lipid Lowering Rx51.12%63.53%
BP Control
MeasuresCY 2005 ResultsMQIC Best Practice
Prescription Filled for Lipid Lowering Drugs63.53%71.50%
Medicaid
2005
Lipid Lowering Rx91.65%
BP Control
MeasuresCY2005 ResultsMQIC Best Practice
Prescription Filled for Lipid Lowering Drugs91.65%99.47%
diabetes non-hedis
00
2004
2005
Measures
Percent
Non-HEDIS Diabetes IndicatorsCommercial MembersCalendar Years 2004 - 2005
diabetes hedis
0
2005
Measure
Percent
Non-HEDIS Diabetes IndicatorsMedicaid MembersCalendar Year 2005
asthma non-hedis
CommercialMedicaidMedicare
200020012002200320042005200620002001200220032004200520062006
Retinal Exams53.46%52.33%56.45%52.54%50.86%54.90%63.55%Retinal Exams43.11%53.51%50.80%41.31%43.61%49.90%55.35%Retinal Exams80.50%
Glyc Hb Testing80.33%84.89%84.12%85.80%84.45%88.02%88.76%Glyc Hb Testing69.33%73.59%75.56%74.73%73.48%81.43%80.05%Glyc Hb Testing93.04%
Glyc HB Poor Control18.02%
20002001200220032004200520062000200120022003200420052006LDL-C Control < 13080.33%
Glyc Hb Poor Control31.19%39.02%28.82%31.64%29.97%27.14%27.65%Glyc Hb Poor Control37.41%46.48%43.16%57.47%52.24%42.70%42.28%LDL-C Control < 10054.37%
LDL-C Testing65.82%76.78%82.92%87.38%89.27%93.32%93.73%LDL-C Testing54.60%63.53%68.49%72.77%72.99%83.54%83.54%Nephropathy Monitoring76.19%
20002001200220032004200520062000200120022003200420052006
LDL-C Control < 13039.25%48.24%56.94%57.58%65.41%71.24%73.04%LDL-C Control < 13027.07%35.79%41.34%41.18%50.79%61.88%63.76%
LDL-C Control < 10037.85%43.08%47.52%LDL-C Control < 10034.11%44.90%46.07%
20002001200220032004200520062000200120022003200420052006
Nephropathy Monitoring42.65%43.73%57.99%62.37%51.77%54.62%61.21%Nephropathy Monitoring45.26%47.62%53.35%54.28%41.02%49.88%53.45%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Retinal Exams66.50%83.78%
Glycosylated Hemoglobin Testing88.90%95.09%
Glycosylated Hemoglobin Poor Control23.60%9.58%
LDL-C Testing93.30%97.81%
LDL-C Control < 130 mg/dL71.60%80.54%
LDL-C Control < 100 mg/dL50.00%54.74%
Nephropathy Monitoring60.20%81.06%
MeasuresHEDIS 2006 ResultsMQIC Best PracticeMeasuresHEDIS 2006 ResultsMQIC Best Practice
Retinal Exams54.80%67.88%Retinal Exams48.60%70.32%
Glycosylated Hemoglobin Testing87.50%91.73%Glycosylated Hemoglobin Testing76.20%88.78%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
MeasuresHEDIS 2006 ResultsMQIC Best PracticeGlycosylated Hemoglobin Poor Control49.10%29.68%
Glycosylated Hemoglobin Poor Control29.70%19.95%LDL-C Testing80.50%91.56%
LDL-C Testing92.30%96.59%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
MeasuresHEDIS 2006 ResultsMQIC Best PracticeLDL-C Control < 130 mg/dL51.30%72.26%
LDL-C Control < 130 mg/dL67.50%81.51%LDL-C Control < 100 mg/dL32.60%62.04%
LDL-C Control < 100 mg/dL43.80%54.26%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Nephropathy Monitoring48.80%65.92%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Nephropathy Monitoring55.10%73.35%
asthma non-hedis
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
asthma-hedis
2006
Measures
Percent
HEDIS Diabetes IndicatorsMedicare MembersHEDIS 2006
depression hedis
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Commercial Members HEDIS 2001 - HEDIS 2006
tobacco control non-hedis
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
tobacco control hedis
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
bcbsm diab hedis
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Medicaid Members HEDIS 2001 - HEDIS 2006
bcbsm diab non-hedis
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Medicaid Members HEDIS 2001 - HEDIS 2006
bcbsm asthma hedis
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Medicaid Members HEDIS 2001 - HEDIS 2006
bcbsm asthma non-hedis
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Medicaid Members HEDIS 2001 - HEDIS 2006
bcbsm tobacco control hedis
Commercial
20012002200320042005
Asthma ER Rate/100076.09115.0262.60131.7897.33
Asthma Px Exams (%)73.6185.9981.8688.1090.66
MeasuresCY 2005 ResultsMQIC Best Practice
Emergency Room Visits for Asthma/1000 Members with Asthma97.3346.76
Periodic Assessment for Asthma90.66%93.69%
Medicaid
2005
Asthma ER Rate/1000160.31
Asthma Px Exams (%)71.35
MeasuresCY 2005 ResultsMQIC Best Practice
Emergency Room Visits for Asthma/1000 Members with Asthma160.3196.88
Periodic Assessment for Asthma71.35%96.55%
bcbsm tobacco control hedis
00000
00000
2001
2002
2003
2004
2005
Measures
Rate
Non-HEDIS Asthma IndicatorsCommercial MembersCalendar Years 2001 - 2005
bcbsm pharyngitis
0
0
2005
Measures
Rate
Non-HEDIS Asthma Indicators Medicaid Members Calendar Year 2005
bcbsm adultprev hedis
Commercial
20002001200220032004
asthma med 5-9 yo65.51%64.49%69.49%63.45%73.57%94.63%
asthma med 10-17 yo64.53%65.35%64.44%58.06%66.80%91.49%
20002001200220032004
asthma med 18-56 yo68.69%67.09%69.84%65.55%72.19%90.27%
asthma med all67.60%66.45%68.75%63.69%71.31%91.13%
Medicaid
20002001200220032004
asthma med 5-9 yo65.22%60.76%61.48%51.11%64.39%87.56%
asthma med 10-17 yo56.04%63.61%64.42%58.98%63.82%86.47%
20002001200220032004
asthma med 18-56 yo62.89%63.43%70.39%68.23%70.03%85.58%
asthma med all61.97%62.90%66.90%62.09%67.07%86.21%
*2005 - Specification Change*2005 - Specification Change
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Appropriate Asthma Medications 5 - 9 Years Old95.70%99.39%
Appropriate Asthma Medications 10 - 17 Years Old91.70%98.15%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Appropriate Asthma Medications 5 - 9 Years Old88.00%94.59%
Appropriate Asthma Medications 10 - 17 Years Old85.60%92.26%
*2005 - Specification Change*2005 - Specification Change
MeasuresHEDIS 2006 ResultsMQIC Best Practice
MeasuresHEDIS 2006 ResultsMQIC Best PracticeAppropriate Asthma Medications 18 - 56 Years Old83.40%91.18%
Appropriate Asthma Medications 18 - 56 Years Old88.50%94.59%Appropriate Asthma Medications Combined Ages85.70%92.18%
Appropriate Asthma Medications Combined Ages89.90%95.91%
bcbsm adultprev hedis
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
pharyngitis
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsMedicaid MembersHEDIS 2001 - HEDIS 2006
hypertension non-hedis
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
hypertension
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsMedicaid MembersHEDIS 2001 - HEDIS 2006
bcbs hyperlipidemia
CommercialMedicare
20022003200420052005
Anti-Dep Med Opt Contact18.91%25.00%25.76%25.72%Anti-Dep Med Opt Contact13.61%
Anti-Dep Med Acute Tx54.92%60.67%56.10%56.94%Anti-Dep Med Acute Tx47.62%
Anti-Dep Med Cont Tx38.01%41.58%38.43%40.07%Anti-Dep Med Cont Tx31.97%
MeasureHEDIS 2006 ResultsMQIC Best Practice
Antidepressant Medications, Optimal Contacts11.80%13.71%
Antidepressant Medications, Effective Acute54.90%47.83%
Treatment Phase
Antidepressant Medication, Effective Continu-41.00%39.13%
ation Treatment Phase
MeasureHEDIS 2006 ResultsMQIC Best Practice
Antidepressant Medications, Optimal Contacts20.60%28.91%
Antidepressant Medications, Effective Acute61.40%63.55%
Treatment Phase
Antidepressant Medication, Effective Continu-45.00%48.19%
ation Treatment Phase
bcbs hyperlipidemia
0000
0000
0000
2002
2003
2004
2005
Measures
Percent
HEDIS Depression IndicatorsCommercial MembersHEDIS 2003 - HEDIS 2006
hyperlipidemia
0
0
0
2005
Measures
Percentage
HEDIS Depression Indicators Medicare Members HEDIS 2006
aaod
Commercial
200320042005
Smoking Prevalence19.67%21.27%15.14%
Quit Rate10.09%10.56%
MeasuresCY 2005 ResultsMQIC Best Practice
Smoking Prevalence15.14%11.87%
Medicaid
20042005
Smoking Prevalence42.28%39.64%
Quit Rate3.51%
MeasuresCalendar Year 2005 ResultsMQIC Best Practice
Smoking Prevalence39.64%37.96%
aaod
000
2003
2004
2005
Measures
Percent
Non-HEDIS Tobacco Control IndicatorsCommercial MembersCalendar Years 2004 - 2005
Sheet3
00
2004
2005
Measures
Percent
Non-HEDIS Tobacco Control IndicatorsMedicaid MembersCalendar Years 2004 - 2005
Sheet2
commercial
200320042005
Adv Smokers to Quit74.90%74.73%69.28%
Disc Smok Cess Meds47.86%46.33%38.55%
Disc Smok Cess Strat41.96%40.57%35.76%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Advising Smokers to Quit71.20%83.33%
Discussion of Smoking Cessation Medications39.40%48.82%
Discussion of Smoking Cessation Strategies39.00%50.16%
Medicaid
20042005
Adv Smokers to Quit67.64%76.60%
Disc Smok Cess Meds38.20%66.42%
Disc Smok Cess Strat32.70%66.79%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Advising Smokers to Quit65.60%75.85%
Discussion of Smoking Cessation Medications31.90%44.68%
Discussion of Smoking Cessation Strategies34.10%50.16%
Sheet2
000
000
000
2003
2004
2005
Measures
Percent
HEDIS Tobacco Control IndicatorsCommercial MembersHEDIS 2004 - HEDIS 2006
adultprev hedis
00
00
00
2004
2005
Measures
Percent
HEDIS Tobacco Control IndicatorsMedicaid MembersHEDIS 2005 - HEDIS 2006
200020012002200320042005
Retinal Exams44.42%43.54%44.80%39.98%32.04%
Glyc Hb Testing68.29%68.28%69.28%77.83%74.79%80.14%
LDL-C Testing71.70%75.54%79.69%82.56%83.56%87.11%
Nephropathy Monitoring22.30%23.03%26.58%32.29%30.04%38.73%
000000
000000
000000
000000
2000
2001
2002
2003
2004
2005
Measures
Percent
HEDIS Diabetes IndicatorsBCBSM MembersHEDIS 2001 - HEDIS 2006
2005
Lipid Lowering Rx63.87%
0
2005
Measures
Percent
Non-HEDIS Diabetes Indicators BCBSM Members Calendar Year 2005
20002001200220032004
asthma med 5-9 yo67.94%69.63%72.16%75.07%76.29%96.89%
asthma med 10-17 yo62.36%64.51%66.40%69.50%70.26%93.74%
20002001200220032004
asthma med 18-56 yo67.55%68.37%72.50%73.30%72.91%90.44%
asthma med all66.62%67.74%71.42%72.81%72.77%91.72%
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsBCBSM MembersHEDIS 2001 - HEDIS 2006
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsBCBS MembersHEDIS 2001 - HEDIS 2006
20012002200320042005
Asthma ER Rate/100052.1957.5452.5749.7844.19
Asthma Px Exams (%)73.2075.8875.9476.3076.09
00000
00000
2001
2002
2003
2004
2005
Measures
Rate
Non-HEDIS Asthma IndicatorsBCBSM MembersCalendar Years 2001-2005
2005
Adv Smokers to Quit72.51%
Disc Smok Cess Meds44.02%
Disc Smok Cess Strat43.41%
0
0
0
2005
Measures
Percent
HEDIS Tobacco Control Indicators BCBSM Members HEDIS 2006
% 2-18 yo tested
20042005
2-18 Years Old Tested54.58%54.17%
00
2004
2005
HEDIS AC Pharyngitis IndicatorsBCBSM MembersHEDIS 2005 - HEDIS 2006
2005
cxcascrg 21-64 yrs74.71%
brcascrg 52-69 yrs71.32%
0
0
2005
Measures
Percent
Adult Preventive Services Indicators BCBSM Members HEDIS 2006 - Baseline
% 2-18 yo tested
20042005
Commercial69.81%63.32%
Medicaid26.60%34.82%
Percent 2 - 18 Years Old Tested for Strept and Were Prescribed an Antibiotic
ProductHEDIS 2006 ResultsMQIC Best Practice
Commercial69.70%74.00%
Medicaid52.00%58.78%
00
00
2004
2005
Product
Percent
HEDIS AC Pharyngitis IndicatorsHEDIS 2005 - HEDIS 2006
Dx HTN
2005
Commercial18.81%
Medicaid11.78%
Medicare71.70%
ProductCY 2005 ResultsMQIC Best Practice
Commercial18.81%12.03%
Medicaid11.78%19.43%
Medicare71.70%69.44%
0
0
0
2005
Product
Percent
Non-HEDIS Hypertension IndicatorPercent Members with any Diagnosis of HypertensionCalendar Year 2005 - Baseline
CBP
20042005
Comm65.86%75.23%
Medicaid57.87%59.23%
Medicare71.70%
ProductHEDIS 2006 ResultsMQIC Best Practice
Commercial68.80%76.86%
Medicaid61.40%75.96%
Medicare66.40%72.26%
00
00
00
2004
2005
Product
Percent
HEDIS Hypertension Indicators - CBP HEDIS 2005 - HEDIS 2006
20042005
CDC LDL-C Testing83.36%
CHM LDL-C Testing74.63%
0
0
2004
Measures
Percent
Hyperlipidemia HEDIS IndicatorsBCBS MembersHEDIS 2005 - HEDIS 2006
comm
20042005
CDC LDL test89.27%
CDC LDL < 130 mg/dL65.41%
CDC LDL < 100 mg/dL37.85%
CHM test78.01%
CHM < 130 mg/dL63.29%
CHM < 100 mg/dL47.35%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
CDC LDL test
CDC LDL < 130 mg/dL
CDC LDL < 100 mg/dL
CHM test
CHM < 130 mg/dL
CHM < 130 mg/dL
Medicaid
20042005
CDC LDL test72.99%
CDC LDL < 130 mg/dL50.79%
CDC LDL < 100 mg/dL34.11%
CHM test57.71%
CHM < 130 mg/dL40.57%
CHM < 100 mg/dL26.86%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
CDC LDL test
CDC LDL < 130 mg/dL
CDC LDL < 100 mg/dL
CHM test
CHM < 130 mg/dL
CHM < 130 mg/dL
0
0
0
0
0
0
2004
Measures
Percent
Hyperlipidemia HEDIS IndicatorsCommercial MembersHEDIS 2005 - HEDIS 2006
0
0
0
0
0
0
2004
Measures
Percent
Hyperlipidemia HEDIS IndicatorsMedicaid MembersHEDIS 2005 - HEDIS 2006
commMedicare
200420052005
Initiation of AAOD Tx55.07%49.52%Initiation of AAOD Tx68.39%
Engagement of AAOD Tx25.10%21.31%Engagement of AAOD Tx5.81%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Initiation of Alcohol & Other Drug Dependence
Treatment50.90%83.33%
Engagement of Alcohol & Other Drug Dependence Treatment4.70%8.33%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Initiation of Alcohol & Other Drug Dependence Treatment44.50%55.65%
Engagement of Alcohol & Other Drug Dependence Treatment14.10%25.00%
00
00
2004
2005
Measures
Percent
Substance Use Disorders HEDIS IndicatorsCommercial MembersHEDIS 2005 - HEDIS 2006
0
0
2005
Measures
Percentage
Substance Use Disorders HEDIS Indicators Medicare Members HEDIS 2006
Commercial
2005
chlamscrg 16-25 yrs39.20%
colcascrg 51-80 yrs58.68%
cxcascrg 21-64 yrs86.59%
brcascrg 52-69 yrs77.82%
Medicaid
2005
chlamscrg 16-25 yrs54.67%
cxcascrg 21-64 yrs64.21%
brcascrg 52-69 yrs57.11%
Medicare
2005
colcascrg 51-80 yrs64.33%
brcascrg 52-69 yrs80.09%
MeasuresHEDIS 2006 ResultsMQIC Best PracticeMeasuresHEDIS 2006 ResultsMQIC Best Practice
Chlamydia Screening Combined16-25 yrs34.90%48.30%Chlamydia Screening Combined16-25 yrs50.60%64.30%
Colorectal Cancer Screening52.30%69.34%Cervical Cancer Screening65.00%74.45%
Cervical Cancer Screening81.80%88.60%Breast Cancer Screening53.90%61.77%
Breast Cancer Screening72.00%82.22%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Colorectal Cancer Screening53.90%69.81%
Breast Cancer Screening71.60%85.97%
0
0
0
2005
Measures
Percent
Adult Preventive Services Indicators Medicaid Members HEDIS 2006 - Baseline
0
0
0
0
2005
Measures
Percent
Adult Preventive Services Indicators Commerical Members HEDIS 2006 - Baseline
0
0
2005
Measures
Percent
Adult Preventive Services Indicators Medicare Members HEDIS 2006 - Baseline
diabetes non-hedis
Commercial
20042005
Lipid Lowering Rx51.12%63.53%
BP Control
MeasuresCY 2005 ResultsMQIC Best Practice
Prescription Filled for Lipid Lowering Drugs63.53%71.50%
Medicaid
2005
Lipid Lowering Rx91.65%
BP Control
MeasuresCY2005 ResultsMQIC Best Practice
Prescription Filled for Lipid Lowering Drugs91.65%99.47%
diabetes non-hedis
00
2004
2005
Measures
Percent
Non-HEDIS Diabetes IndicatorsCommercial MembersCalendar Years 2004 - 2005
diabetes hedis
0
2005
Measure
Percent
Non-HEDIS Diabetes IndicatorsMedicaid MembersCalendar Year 2005
asthma non-hedis
CommercialMedicaidMedicare
200020012002200320042005200620002001200220032004200520062006
Retinal Exams53.46%52.33%56.45%52.54%50.86%54.90%63.55%Retinal Exams43.11%53.51%50.80%41.31%43.61%49.90%55.35%Retinal Exams80.50%
Glyc Hb Testing80.33%84.89%84.12%85.80%84.45%88.02%88.76%Glyc Hb Testing69.33%73.59%75.56%74.73%73.48%81.43%80.05%Glyc Hb Testing93.04%
Glyc HB Poor Control18.02%
20002001200220032004200520062000200120022003200420052006LDL-C Control < 13080.33%
Glyc Hb Poor Control31.19%39.02%28.82%31.64%29.97%27.14%27.65%Glyc Hb Poor Control37.41%46.48%43.16%57.47%52.24%42.70%42.28%LDL-C Control < 10054.37%
LDL-C Testing65.82%76.78%82.92%87.38%89.27%93.32%93.73%LDL-C Testing54.60%63.53%68.49%72.77%72.99%83.54%83.54%Nephropathy Monitoring76.19%
20002001200220032004200520062000200120022003200420052006
LDL-C Control < 13039.25%48.24%56.94%57.58%65.41%71.24%73.04%LDL-C Control < 13027.07%35.79%41.34%41.18%50.79%61.88%63.76%
LDL-C Control < 10037.85%43.08%47.52%LDL-C Control < 10034.11%44.90%46.07%
20002001200220032004200520062000200120022003200420052006
Nephropathy Monitoring42.65%43.73%57.99%62.37%51.77%54.62%61.21%Nephropathy Monitoring45.26%47.62%53.35%54.28%41.02%49.88%53.45%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Retinal Exams66.50%83.78%
Glycosylated Hemoglobin Testing88.90%95.09%
Glycosylated Hemoglobin Poor Control23.60%9.58%
LDL-C Testing93.30%97.81%
LDL-C Control < 130 mg/dL71.60%80.54%
LDL-C Control < 100 mg/dL50.00%54.74%
Nephropathy Monitoring60.20%81.06%
MeasuresHEDIS 2006 ResultsMQIC Best PracticeMeasuresHEDIS 2006 ResultsMQIC Best Practice
Retinal Exams54.80%67.88%Retinal Exams48.60%70.32%
Glycosylated Hemoglobin Testing87.50%91.73%Glycosylated Hemoglobin Testing76.20%88.78%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
MeasuresHEDIS 2006 ResultsMQIC Best PracticeGlycosylated Hemoglobin Poor Control49.10%29.68%
Glycosylated Hemoglobin Poor Control29.70%19.95%LDL-C Testing80.50%91.56%
LDL-C Testing92.30%96.59%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
MeasuresHEDIS 2006 ResultsMQIC Best PracticeLDL-C Control < 130 mg/dL51.30%72.26%
LDL-C Control < 130 mg/dL67.50%81.51%LDL-C Control < 100 mg/dL32.60%62.04%
LDL-C Control < 100 mg/dL43.80%54.26%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Nephropathy Monitoring48.80%65.92%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Nephropathy Monitoring55.10%73.35%
asthma non-hedis
0000000
0000000
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
asthma-hedis
0
0
0
0
0
0
2006
Measures
Percent
HEDIS Diabetes IndicatorsMedicare MembersHEDIS 2006
depression hedis
0000000
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Commercial Members HEDIS 2001 - HEDIS 2006
tobacco control non-hedis
0000000
0000000
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
tobacco control hedis
0000000
0000000
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
bcbsm diab hedis
0000000
0000000
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Medicaid Members HEDIS 2001 - HEDIS 2006
bcbsm diab non-hedis
0000000
0000000
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Medicaid Members HEDIS 2001 - HEDIS 2006
bcbsm asthma hedis
0000000
0000000
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Medicaid Members HEDIS 2001 - HEDIS 2006
bcbsm asthma non-hedis
0000000
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Medicaid Members HEDIS 2001 - HEDIS 2006
bcbsm tobacco control hedis
Commercial
20012002200320042005
Asthma ER Rate/100076.09115.0262.60131.7897.33
Asthma Px Exams (%)73.6185.9981.8688.1090.66
MeasuresCY 2005 ResultsMQIC Best Practice
Emergency Room Visits for Asthma/1000 Members with Asthma97.3346.76
Periodic Assessment for Asthma90.66%93.69%
Medicaid
2005
Asthma ER Rate/1000160.31
Asthma Px Exams (%)71.35
MeasuresCY 2005 ResultsMQIC Best Practice
Emergency Room Visits for Asthma/1000 Members with Asthma160.3196.88
Periodic Assessment for Asthma71.35%96.55%
bcbsm tobacco control hedis
00000
00000
2001
2002
2003
2004
2005
Measures
Rate
Non-HEDIS Asthma IndicatorsCommercial MembersCalendar Years 2001 - 2005
bcbsm pharyngitis
0
0
2005
Measures
Rate
Non-HEDIS Asthma Indicators Medicaid Members Calendar Year 2005
bcbsm adultprev hedis
Commercial
20002001200220032004*2005
asthma med 5-9 yo65.51%64.49%69.49%63.45%73.57%94.63%
asthma med 10-17 yo64.53%65.35%64.44%58.06%66.80%91.49%
20002001200220032004*2005
asthma med 18-56 yo68.69%67.09%69.84%65.55%72.19%90.27%
asthma med all67.60%66.45%68.75%63.69%71.31%91.13%
Medicaid
20002001200220032004*2005
asthma med 5-9 yo65.22%60.76%61.48%51.11%64.39%87.56%
asthma med 10-17 yo56.04%63.61%64.42%58.98%63.82%86.47%
20002001200220032004*2005
asthma med 18-56 yo62.89%63.43%70.39%68.23%70.03%85.58%
asthma med all61.97%62.90%66.90%62.09%67.07%86.21%
*2005 - Specification Change*2005 - Specification Change
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Appropriate Asthma Medications 5 - 9 Years Old95.70%99.39%
Appropriate Asthma Medications 10 - 17 Years Old91.70%98.15%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Appropriate Asthma Medications 5 - 9 Years Old88.00%94.59%
Appropriate Asthma Medications 10 - 17 Years Old85.60%92.26%
*2005 - Specification Change*2005 - Specification Change
MeasuresHEDIS 2006 ResultsMQIC Best Practice
MeasuresHEDIS 2006 ResultsMQIC Best PracticeAppropriate Asthma Medications 18 - 56 Years Old83.40%91.18%
Appropriate Asthma Medications 18 - 56 Years Old88.50%94.59%Appropriate Asthma Medications Combined Ages85.70%92.18%
Appropriate Asthma Medications Combined Ages89.90%95.91%
bcbsm adultprev hedis
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
pharyngitis
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsMedicaid MembersHEDIS 2001 - HEDIS 2006
hypertension non-hedis
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
hypertension
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsMedicaid MembersHEDIS 2001 - HEDIS 2006
bcbs hyperlipidemia
CommercialMedicare
20022003200420052005
Anti-Dep Med Opt Contact18.91%25.00%25.76%25.72%Anti-Dep Med Opt Contact13.61%
Anti-Dep Med Acute Tx54.92%60.67%56.10%56.94%Anti-Dep Med Acute Tx47.62%
Anti-Dep Med Cont Tx38.01%41.58%38.43%40.07%Anti-Dep Med Cont Tx31.97%
MeasureHEDIS 2006 ResultsMQIC Best Practice
Antidepressant Medications, Optimal Contacts11.80%13.71%
Antidepressant Medications, Effective Acute54.90%47.83%
Treatment Phase
Antidepressant Medication, Effective Continu-41.00%39.13%
ation Treatment Phase
MeasureHEDIS 2006 ResultsMQIC Best Practice
Antidepressant Medications, Optimal Contacts20.60%28.91%
Antidepressant Medications, Effective Acute61.40%63.55%
Treatment Phase
Antidepressant Medication, Effective Continu-45.00%48.19%
ation Treatment Phase
bcbs hyperlipidemia
0000
0000
0000
2002
2003
2004
2005
Measures
Percent
HEDIS Depression IndicatorsCommercial MembersHEDIS 2003 - HEDIS 2006
hyperlipidemia
0
0
0
2005
Measures
Percentage
HEDIS Depression Indicators Medicare Members HEDIS 2006
aaod
Commercial
200320042005
Smoking Prevalence19.67%21.27%15.14%
Quit Rate10.09%10.56%
MeasuresCY 2005 ResultsMQIC Best Practice
Smoking Prevalence15.14%11.87%
Medicaid
20042005
Smoking Prevalence42.28%39.64%
Quit Rate3.51%
MeasuresCalendar Year 2005 ResultsMQIC Best Practice
Smoking Prevalence39.64%37.96%
aaod
000
2003
2004
2005
Measures
Percent
Non-HEDIS Tobacco Control IndicatorsCommercial MembersCalendar Years 2004 - 2005
Sheet3
00
2004
2005
Measures
Percent
Non-HEDIS Tobacco Control IndicatorsMedicaid MembersCalendar Years 2004 - 2005
Sheet2
commercial
200320042005
Adv Smokers to Quit74.90%74.73%69.28%
Disc Smok Cess Meds47.86%46.33%38.55%
Disc Smok Cess Strat41.96%40.57%35.76%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Advising Smokers to Quit71.20%83.33%
Discussion of Smoking Cessation Medications39.40%48.82%
Discussion of Smoking Cessation Strategies39.00%50.16%
Medicaid
20042005
Adv Smokers to Quit67.64%76.60%
Disc Smok Cess Meds38.20%66.42%
Disc Smok Cess Strat32.70%66.79%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Advising Smokers to Quit65.60%75.85%
Discussion of Smoking Cessation Medications31.90%44.68%
Discussion of Smoking Cessation Strategies34.10%50.16%
Sheet2
000
000
000
2003
2004
2005
Measures
Percent
HEDIS Tobacco Control IndicatorsCommercial MembersHEDIS 2004 - HEDIS 2006
adultprev hedis
00
00
00
2004
2005
Measures
Percent
HEDIS Tobacco Control IndicatorsMedicaid MembersHEDIS 2005 - HEDIS 2006
200020012002200320042005
Retinal Exams44.42%43.54%44.80%39.98%32.04%
Glyc Hb Testing68.29%68.28%69.28%77.83%74.79%80.14%
LDL-C Testing71.70%75.54%79.69%82.56%83.56%87.11%
Nephropathy Monitoring22.30%23.03%26.58%32.29%30.04%38.73%
000000
000000
000000
000000
2000
2001
2002
2003
2004
2005
Measures
Percent
HEDIS Diabetes IndicatorsBCBSM MembersHEDIS 2001 - HEDIS 2006
2005
Lipid Lowering Rx63.87%
0
2005
Measures
Percent
Non-HEDIS Diabetes Indicators BCBSM Members Calendar Year 2005
20002001200220032004*2005
asthma med 5-9 yo67.94%69.63%72.16%75.07%76.29%96.89%
asthma med 10-17 yo62.36%64.51%66.40%69.50%70.26%93.74%
20002001200220032004*2005
asthma med 18-56 yo67.55%68.37%72.50%73.30%72.91%90.44%
asthma med all66.62%67.74%71.42%72.81%72.77%91.72%
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsBCBSM MembersHEDIS 2001 - HEDIS 2006
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsBCBS MembersHEDIS 2001 - HEDIS 2006
20012002200320042005
Asthma ER Rate/100052.1957.5452.5749.7844.19
Asthma Px Exams (%)73.2075.8875.9476.3076.09
00000
00000
2001
2002
2003
2004
2005
Measures
Rate
Non-HEDIS Asthma IndicatorsBCBSM MembersCalendar Years 2001-2005
2005
Adv Smokers to Quit72.51%
Disc Smok Cess Meds44.02%
Disc Smok Cess Strat43.41%
0
0
0
2005
Measures
Percent
HEDIS Tobacco Control Indicators BCBSM Members HEDIS 2006
% 2-18 yo tested
20042005
2-18 Years Old Tested54.58%54.17%
00
2004
2005
HEDIS AC Pharyngitis IndicatorsBCBSM MembersHEDIS 2005 - HEDIS 2006
2005
cxcascrg 21-64 yrs74.71%
brcascrg 52-69 yrs71.32%
0
0
2005
Measures
Percent
Adult Preventive Services Indicators BCBSM Members HEDIS 2006 - Baseline
% 2-18 yo tested
20042005
Commercial69.81%63.32%
Medicaid26.60%34.82%
Percent 2 - 18 Years Old Tested for Strept and Were Prescribed an Antibiotic
ProductHEDIS 2006 ResultsMQIC Best Practice
Commercial69.70%74.00%
Medicaid52.00%58.78%
00
00
2004
2005
Product
Percent
HEDIS AC Pharyngitis IndicatorsHEDIS 2005 - HEDIS 2006
Dx HTN
2005
Commercial18.81%
Medicaid11.78%
Medicare71.70%
ProductCY 2005 ResultsMQIC Best Practice
Commercial18.81%12.03%
Medicaid11.78%19.43%
Medicare71.70%69.44%
0
0
0
2005
Product
Percent
Non-HEDIS Hypertension IndicatorPercent Members with any Diagnosis of HypertensionCalendar Year 2005 - Baseline
CBP
20042005
Comm65.86%75.23%
Medicaid57.87%59.23%
Medicare71.70%
ProductHEDIS 2006 ResultsMQIC Best Practice
Commercial68.80%76.86%
Medicaid61.40%75.96%
Medicare66.40%72.26%
00
00
00
2004
2005
Product
Percent
HEDIS Hypertension Indicators - CBP HEDIS 2005 - HEDIS 2006
20042005
CDC LDL-C Testing83.36%
CHM LDL-C Testing74.63%
0
0
2004
Measures
Percent
Hyperlipidemia HEDIS IndicatorsBCBS MembersHEDIS 2005 - HEDIS 2006
comm
20042005
CDC LDL test89.27%
CDC LDL < 130 mg/dL65.41%
CDC LDL < 100 mg/dL37.85%
CHM test78.01%
CHM < 130 mg/dL63.29%
CHM < 100 mg/dL47.35%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
CDC LDL test
CDC LDL < 130 mg/dL
CDC LDL < 100 mg/dL
CHM test
CHM < 130 mg/dL
CHM < 130 mg/dL
Medicaid
20042005
CDC LDL test72.99%
CDC LDL < 130 mg/dL50.79%
CDC LDL < 100 mg/dL34.11%
CHM test57.71%
CHM < 130 mg/dL40.57%
CHM < 100 mg/dL26.86%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
CDC LDL test
CDC LDL < 130 mg/dL
CDC LDL < 100 mg/dL
CHM test
CHM < 130 mg/dL
CHM < 130 mg/dL
0
0
0
0
0
0
2004
Measures
Percent
Hyperlipidemia HEDIS IndicatorsCommercial MembersHEDIS 2005 - HEDIS 2006
0
0
0
0
0
0
2004
Measures
Percent
Hyperlipidemia HEDIS IndicatorsMedicaid MembersHEDIS 2005 - HEDIS 2006
commMedicare
200420052005
Initiation of AAOD Tx55.07%49.52%Initiation of AAOD Tx68.39%
Engagement of AAOD Tx25.10%21.31%Engagement of AAOD Tx5.81%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Initiation of Alcohol & Other Drug Dependence
Treatment50.90%83.33%
Engagement of Alcohol & Other Drug Dependence Treatment4.70%8.33%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Initiation of Alcohol & Other Drug Dependence Treatment44.50%55.65%
Engagement of Alcohol & Other Drug Dependence Treatment14.10%25.00%
00
00
2004
2005
Measures
Percent
Substance Use Disorders HEDIS IndicatorsCommercial MembersHEDIS 2005 - HEDIS 2006
0
0
2005
Measures
Percentage
Substance Use Disorders HEDIS Indicators Medicare Members HEDIS 2006
Commercial
2005
chlamscrg 16-25 yrs39.20%
colcascrg 51-80 yrs58.68%
cxcascrg 21-64 yrs86.59%
brcascrg 52-69 yrs77.82%
Medicaid
2005
chlamscrg 16-25 yrs54.67%
cxcascrg 21-64 yrs64.21%
brcascrg 52-69 yrs57.11%
Medicare
2005
colcascrg 51-80 yrs64.33%
brcascrg 52-69 yrs80.09%
MeasuresHEDIS 2006 ResultsMQIC Best PracticeMeasuresHEDIS 2006 ResultsMQIC Best Practice
Chlamydia Screening Combined16-25 yrs34.90%48.30%Chlamydia Screening Combined16-25 yrs50.60%64.30%
Colorectal Cancer Screening52.30%69.34%Cervical Cancer Screening65.00%74.45%
Cervical Cancer Screening81.80%88.60%Breast Cancer Screening53.90%61.77%
Breast Cancer Screening72.00%82.22%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Colorectal Cancer Screening53.90%69.81%
Breast Cancer Screening71.60%85.97%
0
0
0
2005
Measures
Percent
Adult Preventive Services Indicators Medicaid Members HEDIS 2006 - Baseline
0
0
0
0
2005
Measures
Percent
Adult Preventive Services Indicators Commerical Members HEDIS 2006 - Baseline
0
0
2005
Measures
Percent
Adult Preventive Services Indicators Medicare Members HEDIS 2006 - Baseline
Chart3
0.39250.48240.56940.57580.65410.71240.7304
LDL-C Control < 100LDL-C Control < 100LDL-C Control < 100LDL-C Control < 1000.37850.43080.4752
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
diabetes non-hedis
Commercial
20042005
Lipid Lowering Rx51.12%63.53%
BP Control
MeasuresCY 2005 ResultsMQIC Best Practice
Prescription Filled for Lipid Lowering Drugs63.53%71.50%
Medicaid
2005
Lipid Lowering Rx91.65%
BP Control
MeasuresCY2005 ResultsMQIC Best Practice
Prescription Filled for Lipid Lowering Drugs91.65%99.47%
diabetes non-hedis
00
2004
2005
Measures
Percent
Non-HEDIS Diabetes IndicatorsCommercial MembersCalendar Years 2004 - 2005
diabetes hedis
0
2005
Measure
Percent
Non-HEDIS Diabetes IndicatorsMedicaid MembersCalendar Year 2005
asthma non-hedis
CommercialMedicaidMedicare
200020012002200320042005200620002001200220032004200520062006
Retinal Exams53.46%52.33%56.45%52.54%50.86%54.90%63.55%Retinal Exams43.11%53.51%50.80%41.31%43.61%49.90%55.35%Retinal Exams80.50%
Glyc Hb Testing80.33%84.89%84.12%85.80%84.45%88.02%88.76%Glyc Hb Testing69.33%73.59%75.56%74.73%73.48%81.43%80.05%Glyc Hb Testing93.04%
Glyc HB Poor Control18.02%
20002001200220032004200520062000200120022003200420052006LDL-C Control < 13080.33%
Glyc Hb Poor Control31.19%39.02%28.82%31.64%29.97%27.14%27.65%Glyc Hb Poor Control37.41%46.48%43.16%57.47%52.24%42.70%42.28%LDL-C Control < 10054.37%
LDL-C Testing65.82%76.78%82.92%87.38%89.27%93.32%93.73%LDL-C Testing54.60%63.53%68.49%72.77%72.99%83.54%83.54%Nephropathy Monitoring76.19%
20002001200220032004200520062000200120022003200420052006
LDL-C Control < 13039.25%48.24%56.94%57.58%65.41%71.24%73.04%LDL-C Control < 13027.07%35.79%41.34%41.18%50.79%61.88%63.76%
LDL-C Control < 10037.85%43.08%47.52%LDL-C Control < 10034.11%44.90%46.07%
20002001200220032004200520062000200120022003200420052006
Nephropathy Monitoring42.65%43.73%57.99%62.37%51.77%54.62%61.21%Nephropathy Monitoring45.26%47.62%53.35%54.28%41.02%49.88%53.45%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Retinal Exams66.50%83.78%
Glycosylated Hemoglobin Testing88.90%95.09%
Glycosylated Hemoglobin Poor Control23.60%9.58%
LDL-C Testing93.30%97.81%
LDL-C Control < 130 mg/dL71.60%80.54%
LDL-C Control < 100 mg/dL50.00%54.74%
Nephropathy Monitoring60.20%81.06%
MeasuresHEDIS 2006 ResultsMQIC Best PracticeMeasuresHEDIS 2006 ResultsMQIC Best Practice
Retinal Exams54.80%67.88%Retinal Exams48.60%70.32%
Glycosylated Hemoglobin Testing87.50%91.73%Glycosylated Hemoglobin Testing76.20%88.78%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
MeasuresHEDIS 2006 ResultsMQIC Best PracticeGlycosylated Hemoglobin Poor Control49.10%29.68%
Glycosylated Hemoglobin Poor Control29.70%19.95%LDL-C Testing80.50%91.56%
LDL-C Testing92.30%96.59%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
MeasuresHEDIS 2006 ResultsMQIC Best PracticeLDL-C Control < 130 mg/dL51.30%72.26%
LDL-C Control < 130 mg/dL67.50%81.51%LDL-C Control < 100 mg/dL32.60%62.04%
LDL-C Control < 100 mg/dL43.80%54.26%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Nephropathy Monitoring48.80%65.92%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Nephropathy Monitoring55.10%73.35%
asthma non-hedis
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
asthma-hedis
2006
Measures
Percent
HEDIS Diabetes IndicatorsMedicare MembersHEDIS 2006
depression hedis
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Commercial Members HEDIS 2001 - HEDIS 2006
tobacco control non-hedis
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
tobacco control hedis
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
bcbsm diab hedis
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Medicaid Members HEDIS 2001 - HEDIS 2006
bcbsm diab non-hedis
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Medicaid Members HEDIS 2001 - HEDIS 2006
bcbsm asthma hedis
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Medicaid Members HEDIS 2001 - HEDIS 2006
bcbsm asthma non-hedis
2000
2001
2002
2003
2004
2005
2006
Measures
Percent
HEDIS Diabetes Indicators Medicaid Members HEDIS 2001 - HEDIS 2006
bcbsm tobacco control hedis
Commercial
20012002200320042005
Asthma ER Rate/100076.09115.0262.60131.7897.33
Asthma Px Exams (%)73.6185.9981.8688.1090.66
MeasuresCY 2005 ResultsMQIC Best Practice
Emergency Room Visits for Asthma/1000 Members with Asthma97.3346.76
Periodic Assessment for Asthma90.66%93.69%
Medicaid
2005
Asthma ER Rate/1000160.31
Asthma Px Exams (%)71.35
MeasuresCY 2005 ResultsMQIC Best Practice
Emergency Room Visits for Asthma/1000 Members with Asthma160.3196.88
Periodic Assessment for Asthma71.35%96.55%
bcbsm tobacco control hedis
00000
00000
2001
2002
2003
2004
2005
Measures
Rate
Non-HEDIS Asthma IndicatorsCommercial MembersCalendar Years 2001 - 2005
bcbsm pharyngitis
0
0
2005
Measures
Rate
Non-HEDIS Asthma Indicators Medicaid Members Calendar Year 2005
bcbsm adultprev hedis
Commercial
20002001200220032004
asthma med 5-9 yo65.51%64.49%69.49%63.45%73.57%94.63%
asthma med 10-17 yo64.53%65.35%64.44%58.06%66.80%91.49%
20002001200220032004
asthma med 18-56 yo68.69%67.09%69.84%65.55%72.19%90.27%
asthma med all67.60%66.45%68.75%63.69%71.31%91.13%
Medicaid
20002001200220032004
asthma med 5-9 yo65.22%60.76%61.48%51.11%64.39%87.56%
asthma med 10-17 yo56.04%63.61%64.42%58.98%63.82%86.47%
20002001200220032004
asthma med 18-56 yo62.89%63.43%70.39%68.23%70.03%85.58%
asthma med all61.97%62.90%66.90%62.09%67.07%86.21%
*2005 - Specification Change*2005 - Specification Change
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Appropriate Asthma Medications 5 - 9 Years Old95.70%99.39%
Appropriate Asthma Medications 10 - 17 Years Old91.70%98.15%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Appropriate Asthma Medications 5 - 9 Years Old88.00%94.59%
Appropriate Asthma Medications 10 - 17 Years Old85.60%92.26%
*2005 - Specification Change*2005 - Specification Change
MeasuresHEDIS 2006 ResultsMQIC Best Practice
MeasuresHEDIS 2006 ResultsMQIC Best PracticeAppropriate Asthma Medications 18 - 56 Years Old83.40%91.18%
Appropriate Asthma Medications 18 - 56 Years Old88.50%94.59%Appropriate Asthma Medications Combined Ages85.70%92.18%
Appropriate Asthma Medications Combined Ages89.90%95.91%
bcbsm adultprev hedis
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
pharyngitis
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsMedicaid MembersHEDIS 2001 - HEDIS 2006
hypertension non-hedis
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsCommercial MembersHEDIS 2001 - HEDIS 2006
hypertension
000000
000000
2000
2001
2002
2003
2004
*2005
Measures
Percent
HEDIS Asthma IndicatorsMedicaid MembersHEDIS 2001 - HEDIS 2006
bcbs hyperlipidemia
CommercialMedicare
20022003200420052005
Anti-Dep Med Opt Contact18.91%25.00%25.76%25.72%Anti-Dep Med Opt Contact13.61%
Anti-Dep Med Acute Tx54.92%60.67%56.10%56.94%Anti-Dep Med Acute Tx47.62%
Anti-Dep Med Cont Tx38.01%41.58%38.43%40.07%Anti-Dep Med Cont Tx31.97%
MeasureHEDIS 2006 ResultsMQIC Best Practice
Antidepressant Medications, Optimal Contacts11.80%13.71%
Antidepressant Medications, Effective Acute54.90%47.83%
Treatment Phase
Antidepressant Medication, Effective Continu-41.00%39.13%
ation Treatment Phase
MeasureHEDIS 2006 ResultsMQIC Best Practice
Antidepressant Medications, Optimal Contacts20.60%28.91%
Antidepressant Medications, Effective Acute61.40%63.55%
Treatment Phase
Antidepressant Medication, Effective Continu-45.00%48.19%
ation Treatment Phase
bcbs hyperlipidemia
0000
0000
0000
2002
2003
2004
2005
Measures
Percent
HEDIS Depression IndicatorsCommercial MembersHEDIS 2003 - HEDIS 2006
hyperlipidemia
0
0
0
2005
Measures
Percentage
HEDIS Depression Indicators Medicare Members HEDIS 2006
aaod
Commercial
200320042005
Smoking Prevalence19.67%21.27%15.14%
Quit Rate10.09%10.56%
MeasuresCY 2005 ResultsMQIC Best Practice
Smoking Prevalence15.14%11.87%
Medicaid
20042005
Smoking Prevalence42.28%39.64%
Quit Rate3.51%
MeasuresCalendar Year 2005 ResultsMQIC Best Practice
Smoking Prevalence39.64%37.96%
aaod
000
2003
2004
2005
Measures
Percent
Non-HEDIS Tobacco Control IndicatorsCommercial MembersCalendar Years 2004 - 2005
Sheet3
00
2004
2005
Measures
Percent
Non-HEDIS Tobacco Control IndicatorsMedicaid MembersCalendar Years 2004 - 2005
Sheet2
commercial
200320042005
Adv Smokers to Quit74.90%74.73%69.28%
Disc Smok Cess Meds47.86%46.33%38.55%
Disc Smok Cess Strat41.96%40.57%35.76%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Advising Smokers to Quit71.20%83.33%
Discussion of Smoking Cessation Medications39.40%48.82%
Discussion of Smoking Cessation Strategies39.00%50.16%
Medicaid
20042005
Adv Smokers to Quit67.64%76.60%
Disc Smok Cess Meds38.20%66.42%
Disc Smok Cess Strat32.70%66.79%
MeasuresHEDIS 2006 ResultsMQIC Best Practice
Advising Smokers to Quit65.60%75.85%
Discussion of Smoking Cessation Medications31.90%44.68%
Discussion of Smoking Cessation Strategies34.10%50.16%
Sheet2
000
000
000
2003
2004
2005
Measures
Percent
HEDIS Tobacco Control IndicatorsCommercial MembersHEDIS 2004 - HEDIS 2006
adultprev hedis
00