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%
|
|
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%
|
|
65%
|
|
88%
|
|
43%
|
- Medical Attention for Nephropathy
|
84%
|
Care Provided to BCBSIL HMO Members
|
Members Who Received Qualifying Care
|
Musculoskeletal Conditions
|
|
- Disease Modifying Anti-Rheumatic Drug Therapy in 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 Hospitalization 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*
- Initiation Phase
- Continuation and Maintenance Phase
|
26%
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%
|
Care Provided to BCBSIL HMO Members
|
Members Who Received Qualifying Care
|
Use of Services 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%
|
