Care Provided to BCBSIL HMO Members
|
Members Who Received Qualifying Care |
Effectiveness of Care Indicators:
|
2008 |
Prevention and Screening
|
|
- Childhood Immunization Combination 2 Rate
3 DTaP + 3 IPV + 1 MMR + 2 Hib + 3 Hep B + 1 VZV
[In 2009 NCQA allowed reporting only 2 of 3 Hib vaccines due to vaccine shortage.]
|
84% |
- Childhood Immunization Combination 3 Rate: All Combination 2 vaccines + 4 PCV
[In 2009 NCQA allowed reporting only 2 of 3 Hib vaccines due to vaccine shortage.]
|
77% |
- Breast Cancer Screening Age 42-69
|
70% |
- Cervical Cancer Screening
|
78% |
- Colorectal Cancer Screening
|
58% |
- Chlamydia Screening in Women
|
|
|
31% |
|
32% |
|
31% |
Respiratory Conditions
|
|
- Appropriate Testing for Children with Pharyngitis
|
65% |
- Appropriate Treatment for Children with Upper Respiratory Infection
|
79% |
- Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis
|
16% |
- Use of Spirometry Testing in the Assessment and Diagnosis of COPD
|
29% |
- Pharmacotherapy Management of COPD Exacerbation
|
|
- Dispensed systemic corticosteroid within 14 days of event
|
65% |
- Dispensed bronchodilator within 14 days of event
|
78% |
- Use of Appropriate Medications for People with Asthma
|
|
|
97% |
|
93% |
|
92% |
|
93% |
Cardiovascular Conditions
|
|
- Cholesterol Management for Patients with Cardiovascular Conditions
|
|
|
93% |
- LDL-C Control (<100 mg/dL)
|
71% |
- Controlling High Blood Pressure (<140/90)
|
63% |
- Persistence of Beta-Blocker Treatment After a Heart Attack
|
76% |
Comprehensive Diabetes Care:
|
|
- Hemoglobin A1c (HbA1c) Testing
|
90% |
- Poor HbA1c Control (>9.0%) [lower rate is better]
|
28% |
- Hemoglobin A1c Control (<8.0%)
|
62% |
|
|
65% |
|
|
88% |
- LDL-C Control (<100 mg/dL)
|
43% |
- Medical Attention for Nephropathy
|
84% |
- Blood Pressure Control <140/90
|
69% |
- Blood Pressure Control <130/80
|
28% |
Musculoskeletal Conditions
|
|
- Disease Modifying Anti-Rheumatic Drug Therapy for Rheumatoid Arthritis
|
89% |
- Use of Imaging Studies in Low Back Pain
|
74% |
| Medication Management |
|
- Annual Monitoring for Patients on Persistent Medications*
|
|
|
74% |
|
80% |
|
73% |
|
53% |
|
73% |
Behavioral Health
|
|
- Follow Up After Hospitilization for Mental Illness
|
|
|
76% |
|
77% |
- Antidepressant Medication Management
|
|
- Effective Acute Phase Treatment
|
62% |
- Effective Continuation Phase Treatment
|
46% |
- Follow-up Care for Children Prescribed ADHD Medications*
|
|
|
26% |
- Continuation and Maintenance Phase
|
30% |
Measures Collected Through CAHPS® Health Plan Survey
|
|
- Medical Assistance with Smoking Cessation
|
|
|
78% |
|
56% |
|
47% |
- Flu Shots for Adults Age 50-64
|
43% |
Access/Availability of Care Indicators
|
|
- Prenatal and Postpartum Care
|
|
- Timeliness of Prenatal Care
|
96% |
|
80% |
|
|
|
- Call Abandonment [lower the rate = better outcome]
|
2% |
|
81% |
- Initiation and Engagement of Alcohol & Other Drug Dependence Treatment:
|
|
|
43% |
|
10% |
- Adults' Access to Preventive /Ambulatory Health Services*
|
|
|
90% |
|
93% |
|
97% |
- Children and Adolescents' Access to Primary Care Practitioners*
|
|
|
92% |
|
81% |
|
79% |
|
76% |
Use of Service Indicators
|
|
- Well-Child Visits in the First 15 Months of Life*
|
|
|
60% |
|
13% |
|
7% |
|
4% |
|
4% |
|
3% |
|
9% |
- Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life*
|
61% |
- Adolescent Well-Care Visits*
|
35% |
