Healthcare Ensuring Quality Healthcare

• Healthcare Quality Results
• Consumer Satisfaction Survey Results

Results for coverage in 99999

Healthcare Quality Results

To help you select a health plan that meets your needs and your family’s healthcare needs, we developed a quality evaluation system using Healthcare Effectiveness Data and Information Set (HEDIS®) metrics that allows you to gauge health plan performance for significant health issues, including:

• Preventive Care
• Chronic Disease Management
• Medication Use
• Behavioral Health
• Utilization Management

HEDIS metrics are a set of standardized performance measures that allow you to compare Federal Employees Health Benefits (FEHB) health plan performance to industry benchmark percentiles of plan performance using the key below. Plans are displayed based on their average performance on the first three quality measures.

Healthcare Effectiveness Data and Information Set
Plan Name	Controlling High Blood Pressure People with high blood pressure receive effective treatment.	Hemoglobin A1c Control for Patients with Diabetes Do people with diabetes have their condition under control?	Timeliness of Prenatal Care Pregnant women receive care in the first trimester.	Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis Ages 18 to 64 Appropriate use of antibiotics for acute bronchitis.	Asthma Medication Ratio Appropriate ratio of controller medications to total asthma medications.	Breast Cancer Screening Do women who need screening mammograms get them?	Follow Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence 30 day Follow up appointment within 30 days of discharge.	Follow Up After Emergency Department Visit for Mental Illness 30 day Follow up appointment within 30 days of discharge.	Well Child Visits in First 30 Months of Life, First 15 Months Recommended well child visits completed.	Use of Imaging Studies for Low Back Pain Appropriate treatment of lower back pain.
Key: Outstanding Excellent Good Fair Poor       NA NA is displayed if a plan did not report or is unable to report a result in this coverage area.
Panama Canal Area Benefit Plan, High (43)	Fair	Outstanding	Data Not Available	Data Not Available	Data Not Available	Poor	Data Not Available	Data Not Available	Data Not Available	Excellent
Foreign Service Benefit Plan, High (40)	Good	Excellent	Fair	Good	Outstanding	Fair	Fair	Excellent	Poor	Excellent
MHBP - Standard and Value, Value (41)	Fair	Excellent	Excellent	Fair	Good	Poor	Fair	Poor	Poor	Fair
MHBP - Standard and Value, Standard (45)	Fair	Excellent	Excellent	Fair	Good	Poor	Fair	Poor	Poor	Fair
MHBP Consumer Option, HDHP (48)	Fair	Excellent	Excellent	Fair	Good	Poor	Fair	Poor	Poor	Fair
GEHA Indemnity Benefit Plan, Elevate Plus (25)	Fair	Poor	Fair	Excellent	Good	Fair	Poor	Good	Good	Excellent
GEHA Indemnity Benefit Plan, Elevate (25)	Fair	Poor	Fair	Excellent	Good	Fair	Poor	Good	Good	Excellent
APWU Health Plan, CDHP (47)	Fair	Fair	Fair	Fair	Poor	Poor	Poor	Poor	Poor	Good
NALC, High (32)	Excellent	Fair	Fair	Poor	Good	Fair	Fair	Fair	Poor	Fair
Rural Carrier Benefit Plan, High (38)	Good	Good	Excellent	Poor	Fair	Poor	Excellent	Good	Poor	Fair
GEHA Benefit Plan, High (31)	Good	Poor	Good	Fair	Good	Fair	Fair	Fair	Good	Good
GEHA Benefit Plan, Standard (31)	Good	Poor	Good	Fair	Good	Fair	Fair	Fair	Good	Good
GEHA Benefit Plan, HDHP (34)	Good	Poor	Good	Fair	Good	Fair	Fair	Fair	Good	Good
Blue Cross and Blue Shield Service Benefit Plan, Standard (10)	Fair	Fair	Good	Poor	Good	Good	Excellent	Good	Good	Fair
Blue Cross and Blue Shield Service Benefit Plan, Basic (11)	Fair	Fair	Good	Poor	Good	Good	Excellent	Good	Good	Fair
Blue Cross and Blue Shield Service Benefit Plan, FEP Blue Focus (13)	Fair	Fair	Good	Poor	Good	Good	Excellent	Good	Good	Fair
Compass Rose Health Plan, High (42)	Fair	Fair	Fair	Fair	Outstanding	Good	Data Not Available	Data Not Available	Fair	Poor
NALC, CDHP (32)	Poor	Poor	Poor	Good	Poor	Poor	Poor	Fair	Poor	Fair
SAMBA, High (44)	Fair	Poor	Poor	Poor	Excellent	Fair	Data Not Available	Data Not Available	Poor	Fair
SAMBA, Standard (44)	Fair	Poor	Poor	Poor	Excellent	Fair	Data Not Available	Data Not Available	Poor	Fair
APWU Health Plan, High (47)	Poor	Poor	Poor	Poor	Good	Poor	Good	Fair	Poor	Good

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Consumer Satisfaction Survey Results

Each year Federal Employees Health Benefits (FEHB) plans send the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey to a sample of plan members to evaluate their health plan experiences in key areas, including:

• Communication
• Access
• Claims
• Member Experience/Engagement

CAHPS® metrics are a set of standardized performance measures that allow you to compare Federal Employees Health Benefits (FEHB) health plan performance to industry benchmark percentiles of plan performance using the key below. Plans are displayed based on their average performance on the first three quality measures.

Consumer Assessment of Healthcare Providers and Systems
Plan Name	Getting Needed Care Members report getting the care they need.	Claims Processing How quickly do customers say the plan handles claims?	Overall Plan Satisfaction How pleased are customers with the plan overall?	Coordination of Care Members say that their doctors know about care from other providers.
Key: Outstanding Excellent Good Fair Poor       NA NA is displayed if a plan did not report or is unable to report a result in this coverage area.
Blue Cross and Blue Shield Service Benefit Plan, Standard (10)	Good	Excellent	Outstanding	Good
Blue Cross and Blue Shield Service Benefit Plan, Basic (11)	Fair	Excellent	Outstanding	Good
Blue Cross and Blue Shield Service Benefit Plan, FEP Blue Focus (13)	Fair	Good	Good	Fair
GEHA Indemnity Benefit Plan, Elevate Plus (25)	Fair	Poor	Fair	Poor
GEHA Indemnity Benefit Plan, Elevate (25)	Poor	Poor	Fair	Poor
GEHA Benefit Plan, High (31)	Good	Good	Outstanding	Good
GEHA Benefit Plan, Standard (31)	Fair	Data Not Available	Excellent	Data Not Available
NALC, High (32)	Excellent	Good	Excellent	Fair
NALC, CDHP (32)	Poor	Data Not Available	Fair	Data Not Available
GEHA Benefit Plan, HDHP (34)	Fair	Poor	Fair	Poor
Rural Carrier Benefit Plan, High (38)	Excellent	Excellent	Excellent	Fair
Foreign Service Benefit Plan, High (40)	Fair	Good	Excellent	Poor
MHBP - Standard and Value, Value (41)	Outstanding	Data Not Available	Excellent	Outstanding
Compass Rose Health Plan, High (42)	Excellent	Good	Outstanding	Fair
Panama Canal Area Benefit Plan, High (43)	Outstanding	Fair	Outstanding	Good
SAMBA, High (44)	Outstanding	Good	Outstanding	Outstanding
SAMBA, Standard (44)	Fair	Good	Excellent	Poor
MHBP - Standard and Value, Standard (45)	Excellent	Excellent	Outstanding	Good
APWU Health Plan, High (47)	Excellent	Fair	Excellent	Fair
APWU Health Plan, CDHP (47)	Excellent	Poor	Good	Fair
MHBP Consumer Option, HDHP (48)	Poor	Data Not Available	Good	Data Not Available

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• Healthcare Effectiveness Data and Information Set (HEDIS®), source of the data presented on this web page, is a registered trademark of the National Committee for Quality Assurance (NCQA). View more information on the collection and assessment of HEDIS.
• The HEDIS® measures and specifications were developed by and are owned by the National Committee for Quality Assurance ("NCQA"). The HEDIS measures and specifications are not clinical guidelines and do not establish standards of medical care. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures or any data or rates calculated using the HEDIS measures and specifications and NCQA has no liability to anyone who relies on such measures or specifications. © 2012-2015 National Committee for Quality Assurance, all rights reserved.
• The data contained herein is protected by copyright and other intellectual property laws or treatises. Reproduction or use of the data requires permission of NCQA and is subject to a license at the discretion of NCQA. Unauthorized copying or use if prohibited.