Quality Results HEDIS® 2006 Highlights
The Paramount Health Plan Employer
Data and Information Set (HEDIS®)*
2006 and Quality Compass®* results are
available. The HEDIS® data for the 2005
reporting year were submitted for Quality
Compass®, a national database with clinical
performance information from nearly
250 health plans that allows purchasers to
obtain regional and national comparisons
of health plan performance. The HEDIS®
data submitted by Paramount were independently
audited to ensure compliance
with the stringent methodological standards,
with 100 percent of the elements
validated.
We Keep Getting Better
As a result of Paramount’s continued
emphasis on clinical quality, a number
of improvements were realized during
2005. Paramount demonstrated
improvement in 19 of 30 (63 percent)
HEDIS® Effectiveness of Care measures.
Improvements were achieved in the
following areas:
- Adolescent immunizations**
- Advising smokers to quit
- Antidepressant medication management: effective therapy
- Beta-blocker after heart attack
- Beta-blocker: persistent treatment
- Breast cancer screening
- Chlamydia screening: ages 21 to 26
- Colorectal cancer screening
- Childhood immunizations**
- Diabetes: Hb A1c testing and control
- Diabetes: nephropathy monitoring
- Diabetes: LDL control
- Flu shots: adults ages 50 to 64
- Mental health seven- and 30-day follow-up
- Prenatal care
- Postpartum care
- Testing for children with upper respiratory infection
These improvements appear to be a direct result of more specific, targeted interventions, such as:
- A member reminder system for immunizations
- Personalized letters to members with specific testing recommendations
- Educational programs for members with certain conditions
- Physician and office staff education programs
- Direct contact with members and their physicians by Paramount nurse case managers for those with chronic illnesses
- Asthma, depression, congestive heart failure, cardiac postevent, end-stage renal disease/chronic kidney disease and diabetes disease management programs
- Health coaching calls to our asthma, diabetes and cardiac postevent members
Quality Compass® findings also demonstrate that health plans with a track record of public disclosure outperform others and demonstrate steady improvement across almost all measures. For the 2005 reporting year, one HEDIS® measure (diabetes Hb A1c control) ranked in the 90th percentile nationally for the Commercial population. Two additional measures were in the 75th percentile, and five were above the 50th percentile. The area with the lowest level of performance was treatment for dependence on alcohol and other drugs.
To Learn More
If you would like a copy of the
results, please call Member Services
at
*HEDIS® and Quality Compass® are registered trademarks of the National Committee for Quality Assurance.
**Statistically better than last year, P value < 0.01