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Healthcare Ensuring Quality Healthcare

Results for coverage in 76571







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.
People with high blood pressure receive effective treatment.
Hemoglobin A1c Control for Patients with Diabetes Do people with diabetes have their condition under control?
Do people with diabetes have their condition under control?
Timeliness of Prenatal Care Pregnant women receive care in the first trimester.
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.
Appropriate use of antibiotics for acute bronchitis.
Asthma Medication Ratio Appropriate ratio of controller medications to total asthma medications.
Appropriate ratio of controller medications to total asthma medications.
Breast Cancer Screening Do women who need screening mammograms get them?
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 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.
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.
Recommended well child visits completed.
Use of Imaging Studies for Low Back Pain Appropriate treatment of lower 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
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary, High (AS) Fair Excellent Good Poor Fair Fair Poor Poor Fair Good
UnitedHealthcare Insurance Company, Inc. Choice Primary , High (Y8) Fair Excellent Good Poor Fair Fair Poor Poor Fair 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
Aetna HealthFund HDHP and Aetna Direct Plan, HDHP (22) Poor Good Fair Poor Good Fair Poor Poor Fair Fair
Aetna HealthFund CDHP and Aetna Value Plan, CDHP (JS) Poor Good Fair Poor Good Fair Poor Poor Fair Fair
Aetna HealthFund CDHP and Aetna Value Plan, Value (JS) Poor Good Fair Poor Good Fair Poor Poor Fair Fair
Aetna HealthFund HDHP and Aetna Direct Plan, CDHP (N6) Poor Good Fair Poor Good Fair Poor Poor Fair Fair
Aetna Advantage Plan, Advantage (Z2) Poor Good Fair Poor Good Fair Poor Poor Fair Fair
Baylor Scott and White Health Plan, Basic (A8) Poor Poor Fair Poor Poor Good Good Poor Good Good
Baylor Scott and White Health Plan, Standard (A8) Poor Poor Fair Poor Poor Good Good Poor Good Good
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.
Members report getting the care they need.
Claims Processing How quickly do customers say the plan handles claims?
How quickly do customers say the plan handles claims?
Overall Plan Satisfaction How pleased are customers with the plan overall?
How pleased are customers with the plan overall?
Coordination of Care Members say that their doctors know about care from other providers.
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) Excellent Excellent Outstanding Poor
Blue Cross and Blue Shield Service Benefit Plan, Basic (11) Excellent Good Outstanding Fair
Blue Cross and Blue Shield Service Benefit Plan, FEP Blue Focus (13) Data Not Available Data Not Available Excellent Data Not Available
Aetna HealthFund HDHP and Aetna Direct Plan, HDHP (22) Data Not Available Data Not Available Fair Data Not Available
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) Good Data Not Available Outstanding 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
Baylor Scott and White Health Plan, Basic (A8) Poor Data Not Available Fair Good
Baylor Scott and White Health Plan, Standard (A8) Poor Data Not Available Fair Good
UnitedHealthcare Insurance Company, Inc. Choice Plus Primary, High (AS) Fair Good Fair Poor
Aetna HealthFund CDHP and Aetna Value Plan, CDHP (JS) Data Not Available Data Not Available Fair Data Not Available
Aetna HealthFund CDHP and Aetna Value Plan, Value (JS) Data Not Available Data Not Available Fair Data Not Available
Aetna HealthFund HDHP and Aetna Direct Plan, CDHP (N6) Data Not Available Data Not Available Fair Data Not Available
UnitedHealthcare Insurance Company, Inc. Choice Primary , High (Y8) Fair Good Fair Poor
Aetna Advantage Plan, Advantage (Z2) Data Not Available Data Not Available Fair 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.
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