HEDIS® and CAHPS® Reports
Blue Cross and Blue Shield of Illinois (BCBSIL) reports audited HEDIS® results – Health Care Effectiveness Data and Information Set. 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.
HMO
The 2011 BCBSIL HMO HEDIS Report, which is based on 2010 data using HEDIS 2011 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.
View the 2011 HMO HEDIS results 
PPO
The 2011 BCBSIL PPO HEDIS results have been audited. They are based on 2010 data using HEDIS 2011 specifications, and include members residing in Illinois.
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 Healthcare Providers and Systems – Report. The 2011 CAHPS® results are based on care provided in 2010. The following observations 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.
- No significant changes in HMO scores from 2010 to 2011.
- BCBSIL HMOs rank at or above the 75th percentile of national benchmarks on 7 of 9 key composite measures.
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 the QI Executive Summary or call (312) 653-3465 to request additional information about the QI program.
