New Hampshire HEDIS Measure Topic Reports

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New Hampshire HEDIS Measure Topic Reports

• Presentation to the New Hampshire CHIS Users
  Group Meeting, June 27, 2006

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What is HEDIS?

• Health Plan Employer Data and Information Set
• HEDIS is a set of standardized performance
  measures designed to ensure that purchasers and
  consumers have the information they need to
  reliably compare the performance of managed
  health care plans.
• Based upon national guidelines for HEDIS
  reporting set by National Committee for Quality
  Assurance (NCQA)
• Under New Hampshire law (RSA 420-G11, II-a) all
  New Hampshire carriers who collect HEDIS data
  must annually submit the HEDIS information to the
  state.
• National Report- The State of Health Care Quality
• www.ncqa.org

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Understanding the Data

• Does not include Medicaid, Medicare, and the
  uninsured.
• Benchmark data includes an average of
• National - 262 health plans
• New England (NH, ME, MA, CT, RI, VT) - 26 health
  plans
• Northern New England (NH, ME, VT) - 11 health
  plans
• New Hampshire - aggregate of 3 plans
• Anthem - 210,807 member years
• Harvard - 42,242 member years
• CIGNA - 126,598 member years
• Time Period data year 2004 / reporting year
  2005.

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Health Topics Reports

• New Hampshire data presented in the reports
  aggregates results from three NH HealthPlans.
• Data are weighted by member years.
• National and regional benchmarks are included.
• Report topics include
• Child and Adolescent health.
• Womens Health Care.
• Comprehensive Diabetes Care.
• Mental Health Substance Abuse.
• Hospital Utilization.

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HEDIS Measure Results Reviewed
in The Topic Summaries

• Childhood and Adolescent Health
• Access to PCP, Immunizations, Testing for
  Pharyngitis, Treatment of URI, Prescription of
  Asthma Medications.
• Comprehensive Diabetes Care
• Screenings and tests eye exams, blood glucose
  (HbA1c), serum cholesterol level (LDL-C), kidney
  disease screening, Clinical Outcomes poor HbA1c,
  LDL lt100mg.dL.
• Womens Health Care
• Breast cancer screening, Cervical cancer
  screening, Chlamydia screening, Prenatal care and
  postnatal care.
• Mental Health Substance Abuse
• Antidepressant Medication Management, Follow-up
  after Hospitalization for Mental Illness, Mental
  Health Utilization, Chemical Dependency
  Utilization.
• Hospital Utilization
• Inpatient Utilization, Ambulatory Outpatient
  Utilization, Inpatient Utilization for Maternity
  Care, Inpatient Utilization for Newborn Care.

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Sample of Topic Report Content
Mental Health Substance Abuse Report

• Overall introduction to the topic.
• Executive summary of Key Findings for all HEDIS
  measures related to this topic.
• New Hampshire results and comparisons to
  benchmarks for each HEDIS measure.
• Introduction to the measure.
• Specific definition for the measure.
• Results in graphics and written summaries.

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(No Transcript)
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Examples of Key Findings

• Childhood and Adolescent Health
• 96 aged 12 months to19 years have access to a
  PCP.
• 12 of children are not treated properly for an
  URI and 18 are not tested properly for
  pharyngitis.
• Comprehensive Diabetes Care
• HbA1c testing is high at 92 but 20 tested have
  less-healthy results.
• Womens Health Care
• Only 4 of pregnant women did not receive
  prenatal care in their first trimester.
• 16 of NH women in high-risk age category are not
  being screened for breast cancer.
• Mental Health Substance Abuse
• 75 of diagnosed depression patients, who were
  treated with an antidepressant, did not receive
  at least 3 follow-up visits with their health
  care professional.
• Hospital Utilization
• In contrast to Inpatient use rates, NH ambulatory
  Outpatient visit rates/1,000 enrollees were
  higher than all three benchmarks
  national/NE/nNE.

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Appendix-level detail on HEDIS measure results

• Data Tables will be available showing previously
  released HEDIS data for each of three
  HealthPlans, plus NCQA computed benchmarks for
  the Nation, New England and northern New England.

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Sample of Appendix-level data