NCQA’s 2013 State of Health Care Quality Report summarizes healthcare effectiveness data and information set (HEDIS) results from health plans covering a record 136 million people, or 43 percent of the U.S. population. Today, 30 percent

of the population's claims data is processed through the Verisk Health engine.

NCQA’s State of Health Care Quality Report is published in the fall and offers an update on how U.S. healthcare is performing across various measures:

Use HEDIS results to measure performance regarding important dimensions of care and service.

in 2014, compared to 4 retired measures in 2013.

Improvement in MedicareIn 2012, Medicare began making higher payments to health plans with better quality

performance. Measures where we see the largest gains are:

Better Care in MedicaidClinicians and health plans are improving patients’ experience of care, particularly in Medicaid plans. Primary care physicians are not the only ones receiving better CAHPS ratings. The measure, Rating of Specialist, improved 2.3 percentage points to 64.4.

Decline in Alcoholand Drug Treatment

Since 2007, Alcohol and other drug dependence treatment has seen some of the steepest declines of

any measure. Most noteably among Medicare PPOs, where the rate has dropped 13.2 percentage

points, to 43.3 percent.

Childhood VaccinationsThe alarming decline of 3.5 percentage

points in 2009, to 77.7, was the first decrease in the history of the measure. Myths relating vaccines to autism have been further

discredited in recent years.

Since 2010, improvements in Childhood Immunization Status–Influenza include a 6.2

percentage point increase in commercial HMOs, and a 8.7 percentage point increase in commercial PPOs.

A 5.9 increase brought the Medicaid HMO rate to 49.5 over the same period.

CDC Concerns on AntibioticsAntibiotic-resistant bacteria sickens 2

million people and kills 23,000 every year in the U.S. The latest HEDIS results

show little or no progress on overuse of antibiotics, the main cause of

antibiotic resistance.

Rankings are based on each plan’s overall score, which features performance across quality measures.

Across

90%of Health Plans

HEDIS 101Connecting Clinical Quality and Patient Experience

Learn more about how we’re helping Health Plans with HEDIS at:

www.veriskhealth.com/hedis

Sources: Verisk Health DatabaseNCQA, State of Health Care Quality 2013www.ncqa.org

© 2014 Verisk Health

2014 Measures

2013 Findings

25 PointsConsumer

Satisfaction

60 PointsRates for Clinical

Measures

15 PointsNCQA Accreditation

Standards Score

0Retired Measures

have been expanded to create a more accurate snapshot of the related care given to achieve

those measures.

25Measures

in 2014: Non-recommended cervical cancer screening in adolescent females.

1 First Year Measure

758

Quality Measures

Domains ofCare

Bacteria Kills

23,000People in the U.S. Every Year

Childhood Obesity For the first time, the proportion of children enrolled in commercial and Medicaid HMOs who got the recommended BMI assessments exceeded 50 percent. Rates for BMI Percentile Assessment (ages 3 – 17) rose 6.8 percentage points in commercial HMOs, to 51.6, and 5.8 percentage points in Medicaid HMOs, to 51.8.

6.2%Increase Since2010

64.42013 Rating ofSpecialist

6.8%

62.1Colorectal Cancer

Screening

88.9Persistance of Beta-Blocker

Treatment After aHeart Attack

20.0Potentially Harmful

Drug-Disease Interactionsin the Elderly

13.2%

Scores are calculated on a scale of 1–100:

136,000,000 People