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Michigan Quality Improvement Consortium Measurement Committee Year-End Report December 14, 2006

Michigan Quality Improvement Consortium Measurement Committee Year-End Report

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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


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Michigan Radiologic and Imaging Science (MiRIS) Consortium ... · Technologists (ARRT) and the Michigan Radiologic and Imaging Science (MiRIS) consortium. COMPLETION REQUIREMENTS

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