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Federal Employees Health Benefits Program

HEDIS Quality Measures

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You are here: OPM Home > Insurance > FEHB > HEDIS Quality Measures > Group Health Incorporated To information in accessible table format.

Group Health Incorporated

Carrier Code 80

HEDIS (Health Plan Employer Data and Information Set) is developed and maintained by the National Committee for Quality Assurance, a not for profit organization committed to assessing, reporting on, and improving the quality of health care. We present HEDIS results on managed care plans to:

allow consumers to reliably compare health plan performance, and
spur the health plans to make internal efforts at quality improvement.

You can use this information to see how your plan scored against the FEHB average and against other FEHB plans.

If no figure is given for a particular measure it is either because the plan did not report it or there were too few cases to be statistically relevant.

Chart One

Average of all plans =

This plan =

Antidepressant Medication Management			Follow-up After Hospitalization for Mental Illness

Optimal Practioner Contact	Actute Phase Treatment	Continuation Treatment Phase	7 Days	30 Days
Antidepressant Medication Management			Follow-up After Hospitalization for Mental Illness

Chart Two

Average of all plans =

This plan =

Comprehensive Diabetes Care			Prenatal and Postpartum Care

HbA1c Testing	Eye Exams	LDL-C Screening	Timeliness	Postpartum Care
Comprehensive Diabetes Care			Prenatal and Postpartum Care

Chart Three

Average of all plans = This plan =

Beta Blocker Treatment	Breast Cancer Screening	Cervical Cancer Screening	Cholesterol Management After Acute Cardiovascular Events

Beta Blocker Treatment	Breast Cancer Screening	Cervical Cancer Screening	Cholesterol Management After Acute Cardiovascular Events

Chart Four

Average of all plans = This plan =

Childhood Immunization Status

DTP	OPV	MMR	HIB	Hepatitis B	VZV
Childhood Immunization Status

Description Average All Plans This Plan

Antidepressant Medication Management

1. Optimal practitioner contact - the percentage of members 18 and older who were diagnosed with a new episode of depression, treated with an antidepressant medication, and who had at least 3 follow-up contacts with a primary care practitioner or mental health practitioner during the 84-day (12 week) acute treatment phase. 20% 23%

2. Acute treatment phase - the percentage of members 18 and older�who remained on an antidepressant drug during the entire 84-day (12 week) acute treatment phase. 58% 57%

3. Continuation treatment phase - the percentage of members 18 and older�who remained on an antidepressant drug for at least 180 days. 44% 43%

Follow-up After Hospitalization for Mental Illness

4. 7 Days � the percentage of members age six and over who had an ambulatory or day/night visit with a mental health practitioner within 7 days of hospital discharge. 58% N/A

5. 30 Days � the percentage of members age six and over who had an ambulatory or day/night visit with a mental health practitioner within 30 days of hospital discharge. 73% 40%

Comprehensive Diabetes Care

6. HbA1c testing � the percentage of members with diabetes (Type 1 and Type 2) between 18 and 75 who had their Hemoglobin A1c tested. 82% N/A

7. Eye exam � the percentage of members with diabetes (Type 1 and Type 2) between 18 and 75 who had an eye exam for diabetic retinal disease. 55% 28%

8. LDL-C screening � the percentage of members with diabetes (Type 1 and Type 2) between 18 and 75 who had an LDL-C screening. 82% N/A

Prenatal and Postpartum Care

9. Timeliness � the percentage of women who received a prenatal care visit in the first trimester. 86% 59%

10. Postpartum care � the percentage of women who had a postpartum visit on or between 21 days and 56 days after delivery. 77% 31%

Beta Blocker Treatment

11. The percentage of members 35 or older who were hospitalized with a diagnosis of acute myocardial infarction and who received an ambulatory prescription for beta blockers upon discharge. 93% 81%

Breast Cancer Screening

12. The percentage of women age 52 through 69 who had a mammogram during the year. 76% 49%

Cervical Cancer Screening

13. The percentage of women age 21 through 64 who received one or more Pap tests during the year. 80% 61%

Cholesterol Management After Acute Cardiovascular Events

14. The percentage of members 18 through 75 who were discharged for acute myocardial infarction, coronary artery bypass graft, or percutaneous transluminal coronary angioplasty and had evidence of LDL-C screening. 76% 50%

Childhood Immunization Status

15. DTP � the percentage of children who had four DTP (diphtheria, tetanus, and pertussis) before the age of 2. 82% 46%

16. OPV � the percentage of children who had three OPV (oral polio vaccine) before the age of 2. 86% 55%

17. MMR � the percentage of children who had one MMR (measles, mumps, and rubella) before the age of 2. 90% 75%

18. HiB � the percentage of children who had two HiB (H influenza type b) before the age of 2. 84% 46%

19. Hepatitis B � the percentage of children who had three Hepatitis B before the age of 2. 80% 44%

20. VZV � the percentage of children who had one VZV (chicken pox vaccine) before the age of 2. 76% 60%

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