2010 Annual HEDIS® and CAHPS® Reports
Each year Blue Cross and Blue Shield of Illinois (BCBSIL) reports audited HEDIS results — Health Care Effectiveness Data and Information Set — for HMO Illinois and BlueAdvantageSM HMO. HEDIS is a nationally standardized set of measures related to important areas of care and service. Developed by the National Committee for Quality Assurance (NCQA), it is one of the most widely used set of health care performance measures in the United States.
The 2010 BCBSIL HMO HEDIS Report, which is based on 2009 data using HEDIS 2010 specifications, includes measures across seven domains of care that reflect: effectiveness of care, access/availability of care and use of services.
The HMO HEDIS results demonstrate improvements in care for HMO Illinois and BlueAdvantage HMO. Significant improvements were realized for:
- Preventive care: breast cancer screening, flu shots, chlamydia screening, and well-child visits in the first 15 months of life
- Testing: children with pharyngitis, annual monitoring for patients on persistent medications
- Appropriate medications: adults with acute bronchitis, children with upper respiratory infections, disease modifying anti-rheumatic drug therapy in rheumatoid arthritis
- Behavioral health: initiation and engagement of alcohol and other drug dependence treatment, follow-up care during initation for children prescribed ADHD medication
CAHPS® Results Show Member Satisfaction
As part of HEDIS, a survey is sent to a random sample of HMO members. Results of how members feel about their experience with care and service are reported in the CAHPS® — Consumer Assessment of Health Plans Survey — Report. The 2010 CAHPS® results are based on care provided in 2009. The following improvements were noted:
- Member satisfaction with the HMOs of BCBSIL trended upward this year and when combining the 3 most favorable responses (8, 9, and 10 on a 0-10 scale) scored significantly higher than national averages.
- The percent of respondents who gave their health plan's specialists high ratings increased significantly from 2009 to 2010.
- The percent of respondents felt their doctors 'always' or 'usually' explained things in a way that was easy to understand increased significantly from 2009 to 2010.
For More Information
To learn more about the HMO Illinois and BlueAdvantage HMO Quality Improvement (QI) program, including goals, processes and outcomes related to member care and service, view this flier or call 312-653-3465 to request additional information about the QI program.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).