HEDIS VPQHC Quality Report 2008

The Vermont Health Care Quality Report 2008

NCQA HEDIS Measures: Assessing the Quality of Care in Vermont’s Global Commitment to Health Waiver Program

Introduction

The Health Plan Employer Data and Information Set (HEDIS^Ò) is the most widely used set of performance measures by Managed Care Organizations. These standardized HEDIS quality of care performance measures establish the baseline for states to compare the quality of care received by their Medicaid beneficiaries enrolled in a managed care plan or a state run primary care case management program.¹ Accordingly, the information presented is useful for summarizing the quality of care received by specific subpopulations of the Global Commitment program and identifying focus areas for future quality improvement projects.

The scope of work and full report generated for Vermont’s Agency of Human Services summarized sixteen selected measures for use in evaluating the Global Commitment to Health Waiver (GC), a Medicaid Program in Vermont. The report presented a one-year baseline and year one measurement for GC. The NCQA National Medicaid average provided comparison to the rates for Vermont’s Global Commitment Population. While the NCQA National Medicaid average is provided for reference and comparison, some caution should be exercised when comparing Medicaid populations due to variances in policy and regulations. Differences in State policy may influence eligibility and, therefore, the group of individuals comprising the Global Commitment Population may differ from other States’ traditional Medicaid Programs participating reporting NCQA HEDIS measures.

The following HEDIS measures are a subset of those selected by AHS and summarized in this report:

Comprehensive Diabetes Care;
Use of Appropriate Medications for People with Asthma;
Antidepressant Medication Management;
Prenatal Care;
Annual Dental Visits;
Well-Child Visits;
Adolescent Well-Care Visits;
Inpatient Utilization – General Hospital/Acute Care;
Ambulatory Care;
Inpatient Utilization – Non-Acute Care;
Mental Health Utilization – Percentage of Members Receiving Inpatient and Intermediate Care and Ambulatory Services; and
Chemical Dependency Utilization.