Medication Management in Hedis scores

As a consultant, I find it interesting that behavioral health shows the least HEDIS scores.

The National Committee for Quality Assurance developed HEDIS (Healthcare Effective­ness Data and Information Set) as a framework for health plans to collect, analyze and report identical performance measurements each year. The performance measures in HEDIS are related to many significant public health issues. HEDIS allows objective assessment of a health plan’s value in comparison with other health plans.

The scope of the NCQA HEDIS Compliance Audit includes the following domains:

Effectiveness of Care; Access/Availability of Care; Satisfaction with the Experience of Care; Health Plan Stability; Use of Services; Cost of Care; and Health Plan Descriptive Information.

AV health plan:

Antidepressant medication management and compliance:

Optimal practitioner contacts 14.02%

Effective acute phase treatment 60.46%

Effective continuation phase treatment 42.47%

Harvard Pilgrim Health Care – 2007 HEDIS Results
(Calendar year 2006 performance – Reported in September 2007)
Table shows percent of sample meeting HEDIS or CAHPS measurement criteria (see companion Measure Guide for details)

	HPHC, Inc. (MA, ME)	HPHC-NE (NH)	National Average
BEHAVIORAL HEALTH CARE (Adults only)
Antidepressant medication management Optimal practitioner contacts Effective acute-phase treatment Effective continuation-phase treatment	35% 66% 51%	31% 62% 48%	20% 61% 45%
Follow-up appt. after hospitalization for mental illness Within seven days of discharge Within 30 days of discharge	89% 96%	90% 97%	57% 76%
Initiation of alcohol and other drug treatment	45%	41%	43%
Engagement of alcohol and other drug	15%	15%	14%