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HEDIS Rates Summary

The HEDIS 2013 reported rates show improvement on several areas of care such as:

HEDIS Measures

HEDIS 2013 Reported Rate

HEDIS 2014 Reported Rate

Adolescent Well Care

60.58%

62.20%

Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life

62.16%

57.66%

Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life

77.17%

74.21%

Annual Dental Visit: All members

61.93%

64.18%

Breast Cancer

61.23%

68.71%

Cervical Cancer

66.42%

71.05%

Childhood Imm: Combination 2 Immunizations

80.78%

81.26%

Immunizations for Adolescents

82.97%

88.73%

Human Papillomavirus Vaccine for Female Adolescents

26.28%

27.81%

Chlamydia Screening in Women

77.97%

80.05%

Cholesterol Mgmt: LDL-C Screening

85.40%

90.70%

Cholesterol Mgmt: LDL-C Level < 100

41.36%

47.78%

Controlling High BP: Total

55.72%

58.35%

Comp Diabetes Care: HBA1C Testing

81.02%

87.52%

Comp Diabetes Care: HbA1c Poor Control (>9) (Lower score is better)

42.34%

32.95%

Comp Diabetes Care: LDL Less than 100

32.48%

43.59%

Comp Diabetes Care: LDL-C Screening

76.28%

83.03%

Comp Diabetes Care: Monitoring for Nephropathy*

84.49%

87.69%

Freq of Ongoing PNC: More than 81 percent of expected visits

71.05%

74.61%

Prenat Postpart Care: Postpartum care

59.37%

68.60%

Prenat Postpart Care: Timeliness of prenatal care

83.94%

86.86%

Use of Spirometry Testing in the Assessment and Diagnosis of COPD

27.74%

32.30%

Med Mgmt Asthma 13: Total Population 75% Covered

29.72%

32.93%

Weight Assess 13: BMI Screening - Total

61.56%

63.805

Weight Assess 13: Counseling on Nutrition - Total

65.69%

66.23%

Weight Assess 13: Counseling on Physical Activity - Total

48.91%

51.43%

Adult BMI Assmt 13

69.83%

79.87%

Appropriate Testing for Children with Pharyngitis

63.40%

71.67%

Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis

27.00%

35.67%

Use of Spirometry Testing in the Assessment and Diagnosis of COPD

32.30%

32.30%

Use Imaging Low Back

79.42%

81.08%

We believe that Health Partners Plans attributes the increase in the HEDIS rates through several methods such as improvements in provider and member education. Our Healthier You, Baby Partners, EPSDT and Special Needs Units work hard to engage members and build relationships of respect and dignity in order to improve health care outcomes. Health Partners utilizes targeted telephonic outreach to remind members about possible needed screenings. Our Network Account Managers and Quality Management Nurses work with provider’s offices to educate providers and their staff regarding new programs and incentives as well as available resources.

Measures identified for improvement:

HEDIS Measures

HEDIS 2013 Reported Rate

HEDIS 2014 Reported Rate

Comp Diabetes Care: Eye Exam*

64.78%

64.23%

Lead Screening in Children

81.02%

77.48% 

Health Partners Plans Healthier You Program is working closely with members who have a diagnosis of Diabetes in order to assure the members have appropriate screenings and follow up to take control of their Diabetes.  HPP EPSDT department works with providers and families to assure the member receives the appropriate screenings and testings.  HP connect on the provider web page can assist providers in obtaining a member care gap report. This report allows providers to see what members need services, which will help to improve the member’s health, and the providers QCP scores.

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