2017 Health Plan Report Card

Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis (AAB)

Measure description: 
This is the rate of health plan members with acute bronchitis who did not receive an antibiotic prescription.  Such prescriptions to treat people with bronchitis should be avoided.

A higher figure means better performance.

Follow-Up Care for Children Prescribed ADHD Medication (ADD)

Measure description: 
The measure is in regard to children prescribed attention-deficit/hyperactivity disorder (ADHD) medication.  For these children, the measure is the rate who stayed on ADHD medications at least seven months and also had follow up visits.

A higher figure means better performance.

Ambulatory Care: Emergency Department Visits (AMB)

Measure description: 
This is a measure of members using the Emergency Department.  The rates in the table are emergency department visits per 1,000 member years.

A lower figure means better performance.

Antidepressant Medication Management (AMM)

Measure description: 
This is the rate of health plan members with major depression taking antidepressants who stayed on the medication for at least six months.

A higher figure means better performance.

Breast Cancer Screening (BCS)

Measure description: 
This is the rate of health plan members who are women age 50 - 74 that had a mammogram to screen for breast cancer.

A higher figure means better performance.

Controlling High Blood Pressure (CBP)

Measure description: 
This is the rate of health plan members with hypertension that have their blood pressure in control (<140/90) in the prior year.

A higher figure means better performance.

Comprehensive Diabetes Care: Blood Pressure Control (CDC)

Measure description: 
This is the rate of health plan members with diabetes that have their blood pressure in control (< 140/90) in the prior year.

A higher figure means better performance.

Comprehensive Diabetes Care (CDC): Blood Sugar Control

Measure description: 
This is the rate of health plan members with diabetes that have their blood sugar in control (HbA1c < 8%) in the prior year.

A higher figure means better performance.

Colorectal Cancer Screening (COL)

Measure description: 
This is the rate of health plan members 50 - 75 years old that had one of several types of appropriate screens for colorectal cancer.

A higher figure means better performance.

Appropriate Testing for Children with Pharyngitis (CWP)

Measure description:
This is the rate of children with pharyngitis who received a strep test before receiving an antibiotic prescription.  Such prescriptions should only happen if a strep test occurred.

A higher figure means better performance.

Follow Up After Hospitalization for Mental Illness (FUH)

Measure description: 
This measure is in regard to health plan members over age five hospitalized for treatment of certain types of mental illness.  The rate reported is for those who had a follow up appointment with a mental health professional within a week after being discharged from the hospital.

A higher figure means better performance.

Use of Imaging Studies for Low Back Pain (LBP)

Measure description:
This is the rate of health plan members who did not have an X-ray, MRI or CT scan within four weeks of a complaint of low back pain. 

A higher figure means better performance.

Medication Management for People with Asthma (MMA)

Measure description: 
This is the rate of health plan members with persistent asthma age 5 to 64 who stayed on their controller medication for at least 75% of the treatment period.

A higher figure means better performance.

Plan All-Cause Readmissions (PCR)

Measure description: 
This is a measure of members being readmitted back to a hospital within 30 days of being discharged from a hospitalization. 

The measure results in the table below are risk adjusted rates.  A lower figure means better performance.

Appropriate Treatment for Children with Upper Respiratory Infection (URI)

Measure description:
This is the rate of children with upper respiratory infection who were not given an antibiotic prescription. 

A higher figure means better performance.

Care Coordination (survey question #22)

Measure description: 
In a survey, adult health plan members were asked:  “In the last 12 months, how often did your personal doctor seem informed and up-to-date about the care you got from these doctors or other health providers?”

The response options were “never”, “sometimes”, “usually” and “always”.  The result reported is the rate of people that said “always”.

A higher figure means better performance.

Primary Care Physician Rating (survey question #23)

Measure description: 
In a survey, adult health plan members were asked:  “Using any number from 0 to 10, where 0 is the worst personal doctor possible and 10 is the best personal doctor possible, what number would you use to rate your personal doctor?”

The result reported is the rate of people that responded with a “9” or “10”.

A higher figure means better performance.

Specialty Care Physician Rating (survey question #27)

Measure description: 
In a survey, adult health plan members were asked:  “We want to know your rating of the specialist you saw most often in the last 12 months. Using any number from 0 to 10, where 0 is the worst specialist possible and 10 is the best specialist possible, what number would you use to rate that specialist?”

The result reported is the rate of people that responded with a “9” or “10”.

A higher figure means better performance.

Health Plan Rating (survey question #42)

Measure description: 
In a survey, adult health plan members were asked:  “Using any number from 0 to 10, where 0 is the worst health plan possible and 10 is the best health plan possible, what number would you use to rate your health plan?“.

The result reported is the rate of people that responded with a “9” or “10”.

A higher figure means better performance.