This report displays results showing the quality of care members received under each Medicaid and CHIP health plan (i.e., managed care or accountable care organization) and commercial health plan reporting to the Office of Health Care Statistics as measured using HEDIS technical specifications during calendar year 2018. All results were calculated by each individual health plan and validated by an accredited third-party auditor prior to submitting results to the Office of Health Care Statistics at the Utah Department of Health.
The report is separated into two components:
Results are sorted highest to lowest for each quality measure with national averages presented along with plan results. For some measures, rates are not reported for the following reasons determined during the third-party audit:
- No Benefit. The organization did not offer the health benefit required by the measure (e.g., mental health, chemical dependency).
- Small Denominator. The organization followed the specifications, but the denominator was too small (<30) to report a valid rate.
- Not Reported. The organization chose not to report the measure.
Medicaid and CHIP
Results are reported for the following health plans:
- Medicaid
- Health Choice Utah
- Healthy U
- Molina
- SelectHealth Community Care
- CHIP
- Molina
- SelectHealth
For information and results about commercial plans, please see the section covering commercial plans.
Quality Measures
Maternity Care
- Prenatal and Postpartum Care – Postpartum Care
- Prenatal and Postpartum Care – Timeliness of Prenatal Care
Newborn and Infant Care
- Childhood Immunization Status – Combo 3
- Well-Child Visits in the first 15 Months of Life – 6 or more visits
Pediatric Care
- Appropriate Treatment for Children With Upper Respiratory Infection
- Immunizations for Adolescents – Combination 2
- Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents – BMI percentile – Total
- Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life
Adult Care
- Antidepressant Medication Management – Effective Acute Phase Treatment
- Antidepressant Medication Management – Effective Continuation Phase Treatment
- Breast Cancer Screening
- Cervical Cancer Screening
- Comprehensive Diabetes Care – HbA1c Testing
- Comprehensive Diabetes Care – Eye Exams
- Controlling High Blood Pressure
- Follow-Up After Hospitalization For Mental Illness – 7 days – Total
- Follow-Up After Hospitalization For Mental Illness – 30 days – Total
- Initiation and Engagement of Alcohol and Other Drug Dependence Treatment – Initiation of AOD – Total
- Initiation and Engagement of Alcohol and Other Drug Dependence Treatment – Engagement of AOD – Total
- Use of Imaging Studies for Low Back Pain
Maternity Care
Prenatal and Postpartum Care – Postpartum Care
The percentage of deliveries that had a postpartum visit on or between 21 and 56 days after delivery.
| Health Plan | Rate |
|---|---|
| SelectHealth Community Care (Medicaid) | 76% |
| Health Choice Utah (Medicaid) | 66% |
| National Average | 64% |
| Healthy U (Medicaid) | 55% |
| Molina (Medicaid) | 53% |
| Molina (CHIP) | Small Denominator |
| SelectHealth (CHIP) | Not Reported |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Prenatal and Postpartum Care.
Prenatal and Postpartum Care – Timeliness of Prenatal Care
The percentage of deliveries that received a prenatal care visit as a member of the organization in the first trimester, on the enrollment start date or within 42 days of enrollment in the organization.
| Health Plan | Rate |
|---|---|
| SelectHealth Community Care (Medicaid) | 91% |
| National Average | 82% |
| Healthy U (Medicaid) | 74% |
| Health Choice Utah (Medicaid) | 69% |
| Molina (Medicaid) | 62% |
| Molina (CHIP) | Small Denominator |
| SelectHealth (CHIP) | Not Reported |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Prenatal and Postpartum Care.
Newborn and Infant Care
Childhood Immunization Status – Combo 3
The percentage of children 2 years of age who had a four diphtheria, tetanus and acellular pertussis (DTaP); three polio (IPV); one measles, mumps and rubella (MMR); three haemophilus influenza type B (HiB); three hepatitis B (HepB); one chicken pox (VZV); and four pneumococcal conjugate (PCV) by their second birthday.
| Health Plan | Rate |
|---|---|
| Healthy U (Medicaid) | 79% |
| Molina (CHIP) | 79% |
| SelectHealth (CHIP) | 78% |
| SelectHealth Community Care (Medicaid) | 76% |
| Health Choice Utah (Medicaid) | 72% |
| Molina (Medicaid) | 71% |
| National Average | 68% |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Childhood Immunization Status.
Well-Child Visits in the first 15 Months of Life – 6 or more visits
Assesses children who turned 15 months old during the measurement year and had 6 well-child visits with a primary care physician during their first 15 months of life.
| Health Plan | Rate |
|---|---|
| SelectHealth (CHIP) | 74% |
| Molina (CHIP) | 73% |
| SelectHealth Community Care (Medicaid) | 63% |
| National Average | 63% |
| Molina (Medicaid) | 61% |
| Healthy U (Medicaid) | 60% |
| Health Choice Utah (Medicaid) | 59% |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Child and Adolescent Well-Care Visits.
Pediatric Care
Appropriate Treatment for Children With Upper Respiratory Infection
Assesses children 3 months–18 years of age who were given a diagnosis of upper respiratory infection (URI) and were not dispensed an antibiotic prescription. A higher rate indicates appropriate treatment of children with URI (i.e., the proportion for whom antibiotics were not prescribed).
| Health Plan | Rate |
|---|---|
| SelectHealth Community Care (Medicaid) | 95% |
| Healthy U (Medicaid) | 95% |
| Molina (CHIP) | 95% |
| Molina (Medicaid) | 94% |
| Health Choice Utah (Medicaid) | 94% |
| SelectHealth (CHIP) | 94% |
| National Average | 90% |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Appropriate Treatment for Children With Upper Respiratory Infection.
Children and Adolescents Access To PCP – 12-24 Months
Assess children and young adults 12-24 months of age who had a visit with a primary care practitioner (PCP).
| Health Plan | Rate |
|---|---|
| Molina (CHIP) | 99% |
| SelectHealth (CHIP) | 99% |
| SelectHealth Community Care (Medicaid) | 97% |
| Molina (Medicaid) | 97% |
| Healthy U (Medicaid) | 96% |
| National Average | 95% |
| Health Choice Utah (Medicaid) | 94% |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Children and Adolescents’ Access to Primary Care Practitioners.
Immunizations for Adolescents – Combination 2
Assesses adolescents 13 years of age who had one dose of meningococcal vaccine, one Tdap vaccine and the complete human papillomavirus vaccine series by their 13th birthday.
| Health Plan | Rate |
|---|---|
| Healthy U (Medicaid) | 44% |
| Molina (CHIP) | 37% |
| SelectHealth (CHIP) | 37% |
| National Average | 35% |
| SelectHealth Community Care (Medicaid) | 31% |
| Health Choice Utah (Medicaid) | 31% |
| Molina (Medicaid) | 28% |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Immunizations for Adolescents.
Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents – BMI percentile – Total
Assesses children and adolescents 3-17 years of age who had an outpatient visit with a primary care practitioner or OB/GYN during the measurement year and had evidence of Body mass index (BMI) percentile documentation.
| Health Plan | Rate |
|---|---|
| SelectHealth Community Care (Medicaid) | 91% |
| SelectHealth (CHIP) | 89% |
| Healthy U (Medicaid) | 84% |
| National Average | 74% |
| Molina (CHIP) | 64% |
| Molina (Medicaid) | 63% |
| Health Choice Utah (Medicaid) | 57% |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents.
Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life
Assesses children 3-6 years of age who received one or more well-child visits with a primary care practitioner during the measurement year.
| Health Plan | Rate |
|---|---|
| National Average | 72% |
| SelectHealth (CHIP) | 70% |
| Molina (CHIP) | 69% |
| SelectHealth Community Care (Medicaid) | 64% |
| Healthy U (Medicaid) | 64% |
| Molina (Medicaid) | 59% |
| Health Choice Utah (Medicaid) | 58% |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Child and Adolescent Well-Care Visits.
Adult Care
Adult Access to Preventive and Ambulatory Health Services – Total
The percentage of members 20 years and older who had an ambulatory or preventive care visit during the measurement year.
| Healthcare Plan | Value |
|---|---|
| SelectHealth Community Care (Medicaid) | 88% |
| Healthy U (Medicaid) | 85% |
| Health Choice Utah (Medicaid) | 83% |
| Molina (Medicaid) | 83% |
| National Average | 80% |
| Molina (CHIP) | Not Reported |
| SelectHealth (CHIP) | Not Reported |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Adults’ Access to Preventive and Ambulatory Health Services.
Antidepressant Medication Management – Effective Acute Phase Treatment
Assesses adults 18 years of age and older with a diagnosis of major depression who were newly treated with antidepressant medication and remained on an antidepressant medication for at least 84 days (12 weeks).
| Health Plan | Rate |
|---|---|
| SelectHealth Community Care (Medicaid) | 54% |
| National Average | 53% |
| Healthy U (Medicaid) | 47% |
| Health Choice Utah (Medicaid) | Small Denominator |
| Molina (CHIP) | Small Denominator |
| Molina (Medicaid) | Small Denominator |
| SelectHealth (CHIP) | Not Reported |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Antidepressant Medication Management.
Antidepressant Medication Management – Effective Continuation Phase Treatment
Assesses adults 18 years of age and older with a diagnosis of major depression who were newly treated with antidepressant medication and remained on an antidepressant medication for at least 84 days (12 weeks).
| Health Plan | Rate |
|---|---|
| SelectHealth Community Care (Medicaid) | 34% |
| National Average | 38% |
| Healthy U (Medicaid) | 33% |
| Health Choice Utah (Medicaid) | Small Denominator |
| Molina (CHIP) | Small Denominator |
| Molina (Medicaid) | Small Denominator |
| SelectHealth (CHIP) | Not Reported |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Antidepressant Medication Management.
Breast Cancer Screening
Assesses women 50–74 years of age who had at least one mammogram to screen for breast cancer in the past two years.
| Health Plan | Rate |
|---|---|
| National Average | 58% |
| Healthy U (Medicaid) | 48% |
| SelectHealth Community Care (Medicaid) | 47% |
| Molina (Medicaid) | 40% |
| Health Choice Utah (Medicaid) | 29% |
| Molina (CHIP) | Not Reported |
| SelectHealth (CHIP) | Small Denominator |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Breast Cancer Screening.
Cervical Cancer Screening
Assesses women 21–64 years of age who were screened for cervical cancer using either of the following criteria:
- Women age 21–64 who had cervical cytology performed every 3 years.
- Women age 30–64 who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years.
| Health Plan | Rate |
|---|---|
| National Average | 59% |
| SelectHealth Community Care (Medicaid) | 57% |
| Healthy U (Medicaid) | 57% |
| Molina (Medicaid) | 53% |
| Health Choice Utah (Medicaid) | 44% |
| Molina (CHIP) | Not Reported |
| SelectHealth (CHIP) | Not Reported |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Cervical Cancer Screening.
Comprehensive Diabetes Care – HbA1c Testing
Assesses adults 18–75 years of age with diabetes (type 1 and type 2) who had Hemoglobin A1c (HbA1c) testing.
| Health Plan | Rate |
|---|---|
| SelectHealth Community Care (Medicaid) | 89% |
| Healthy U (Medicaid) | 89% |
| National Average | 88% |
| Molina (Medicaid) | 87% |
| Health Choice Utah (Medicaid) | 82% |
| Molina (CHIP) | Not Reported |
| SelectHealth (CHIP) | Not Reported |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Comprehensive Diabetes Care.
Comprehensive Diabetes Care – Eye Exams
Assesses adults 18–75 years of age with diabetes (type 1 and type 2) who had an eye exam (retinal) performed.
| Health Plan | Rate |
|---|---|
| SelectHealth Community Care (Medicaid) | 66% |
| National Average | 57% |
| Healthy U (Medicaid) | 56% |
| Molina (Medicaid) | 52% |
| Health Choice Utah (Medicaid) | 49% |
| Molina (CHIP) | Not Reported |
| SelectHealth (CHIP) | Not Reported |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Comprehensive Diabetes Care.
Controlling High Blood Pressure
Assesses adults 18–85 years of age with a diagnosis of hypertension and whose blood pressure was adequately controlled based on the following criteria:
- Adults 18-59 years of age whose blood pressure was <140/90 mm Hg.
- Adults 60-85 years of age, with a diagnosis of diabetes, whose blood pressure was <140/90 mm Hg.
- Adults 60-85 years of age, without a diagnosis of diabetes, whose blood pressure was <150/90 mm Hg.
| Health Plan | Rate |
|---|---|
| Healthy U (Medicaid) | 76% |
| SelectHealth Community Care (Medicaid) | 73% |
| Health Choice Utah (Medicaid) | 61% |
| National Average | 59% |
| Molina (Medicaid) | 55% |
| Molina (CHIP) | Not Reported |
| SelectHealth (CHIP) | Not Reported |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Controlling High Blood Pressure.
Follow-Up After Hospitalization For Mental Illness – 7 days – Total
Assesses adults and children 6 years of age and older who were hospitalized for treatment of selected mental illness or intentional self-harm and had an outpatient visit, an intensive outpatient encounter or a partial hospitalization with a mental health practitioner. The measure identifies the percentage of members who received follow-up within 7 days of discharge.
| Healthcare Plan | Value |
|---|---|
| National Average | 36% |
| SelectHealth (CHIP) | 32% |
| Health Choice Utah (Medicaid) | No Benefit |
| Healthy U (Medicaid) | No Benefit |
| Molina (CHIP) | Small Denominator |
| Molina (Medicaid) | Small Denominator |
| SelectHealth Community Care (Medicaid) | No Benefit |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Follow-Up After Hospitalization for Mental Illness.
Follow-Up After Hospitalization For Mental Illness – 30 days – Total
Assesses adults and children 6 years of age and older who were hospitalized for treatment of selected mental illness or intentional self-harm and had an outpatient visit, an intensive outpatient encounter or a partial hospitalization with a mental health practitioner. The measure identifies the percentage of members who received follow-up within 30 days of discharge.
| Healthcare Plan | Value |
|---|---|
| SelectHealth (CHIP) | 61% |
| National Average | 57% |
| Health Choice Utah (Medicaid) | No Benefit |
| Healthy U (Medicaid) | No Benefit |
| Molina (CHIP) | Small Denominator |
| Molina (Medicaid) | Small Denominator |
| SelectHealth Community Care (Medicaid) | No Benefit |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Follow-Up After Hospitalization for Mental Illness.
Initiation and Engagement of Alcohol and Other Drug Dependence Treatment – Initiation of AOD – Total
Assesses adults and adolescents 13 years of age and older with a new episode of alcohol or other drug (AOD) dependence who initiated treatment through an inpatient AOD admission, outpatient visit, intensive outpatient encounter or partial hospitalization, telehealth or medication-assisted treatment (MAT) within 14 days of diagnosis.
| Healthcare Plan | Value |
|---|---|
| National Average | 43% |
| Health Choice Utah (Medicaid) | No Benefit |
| Healthy U (Medicaid) | No Benefit |
| Molina (CHIP) | Not Reported |
| Molina (Medicaid) | Not Reported |
| SelectHealth Community Care (Medicaid) | No Benefit |
| SelectHealth (CHIP) | Small Denominator |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment.
Initiation and Engagement of Alcohol and Other Drug Dependence Treatment – Engagement of AOD – Total
Assesses adults and adolescents 13 years of age and older with a new episode of alcohol or other drug (AOD) dependence who initiated treatment and had two or more additional AOD services or MAT within 34 days of the initiation visit.
| Healthcare Plan | Value |
|---|---|
| National Average | 14% |
| Health Choice Utah (Medicaid) | No Benefit |
| Healthy U (Medicaid) | No Benefit |
| Molina (CHIP) | Not Reported |
| Molina (Medicaid) | Not Reported |
| SelectHealth (CHIP) | Small Denominator |
| SelectHealth Community Care (Medicaid) | No Benefit |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment.
Use of Imaging Studies for Low Back Pain
Assesses adults 18–50 with a primary diagnosis of low back pain who did not have an imaging study (plain X-ray, MRI or CT scan) within 28 days of the diagnosis (a higher score indicates better performance).
| Health Plan | Rate |
|---|---|
| Health Choice Utah (Medicaid) | 80% |
| SelectHealth Community Care (Medicaid) | 74% |
| Healthy U (Medicaid) | 72% |
| National Average | 72% |
| Molina (Medicaid) | 67% |
| Molina (CHIP) | Not Reported |
| SelectHealth (CHIP) | Small Denominator |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Use of Imaging Studies for Low Back Pain.
Commercial
Results are reported for the following health plans:
- Aetna Health
- Aetna Life
- Cigna
- EMI
- Humana
- Regence BCBS
- SelectHealth
- United
For information and results about Medicaid and CHIP plans, please see the section covering Medicaid and CHIP plans.
Quality Measures
Maternity Care
- Prenatal and Postpartum Care – Postpartum Care
- Prenatal and Postpartum Care – Timeliness of Prenatal Care
Newborn and Infant Care
- Childhood Immunization Status – Combo 3
- Well-Child Visits in the first 15 Months of Life – 6 or more visits
Pediatric Care
- Appropriate Treatment for Children With Upper Respiratory Infection
- Immunizations for Adolescents – Combination 2
- Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents – BMI percentile – Total
- Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life
Adult Care
- Antidepressant Medication Management – Effective Acute Phase Treatment
- Antidepressant Medication Management – Effective Continuation Phase Treatment
- Breast Cancer Screening
- Cervical Cancer Screening
- Comprehensive Diabetes Care – HbA1c Testing
- Comprehensive Diabetes Care – Eye Exams
- Controlling High Blood Pressure
- Follow-Up After Hospitalization For Mental Illness – 7 days – Total
- Follow-Up After Hospitalization For Mental Illness – 30 days – Total
- Initiation and Engagement of Alcohol and Other Drug Dependence Treatment – Initiation of AOD – Total
- Initiation and Engagement of Alcohol and Other Drug Dependence Treatment – Engagement of AOD – Total
- Use of Imaging Studies for Low Back Pain
Maternity Care
Prenatal and Postpartum Care – Postpartum Care
The percentage of deliveries that had a postpartum visit on or between 21 and 56 days after delivery.
| Health Plan | Rate |
|---|---|
| SelectHealth | 89% |
| United | 79% |
| Regence BCBS | 73% |
| National Average | 73% |
| Aetna Health | 70% |
| Aetna Life | 48% |
| Cigna | 47% |
| EMI | 47% |
| Humana | Small Denominator |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Prenatal and Postpartum Care.
Prenatal and Postpartum Care – Timeliness of Prenatal Care
The percentage of deliveries that received a prenatal care visit as a member of the organization in the first trimester, on the enrollment start date or within 42 days of enrollment in the organization.
| Health Plan | Rate |
|---|---|
| SelectHealth | 95% |
| National Average | 82% |
| United | 81% |
| Aetna Health | 77% |
| Regence BCBS | 69% |
| Cigna | 24% |
| EMI | 22% |
| Humana | Small Denominator |
| Aetna Life | Not Reported |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Prenatal and Postpartum Care.
Newborn and Infant Care
Childhood Immunization Status – Combo 3
The percentage of children 2 years of age who had a four diphtheria, tetanus and acellular pertussis (DTaP); three polio (IPV); one measles, mumps and rubella (MMR); three haemophilus influenza type B (HiB); three hepatitis B (HepB); one chicken pox (VZV); and four pneumococcal conjugate (PCV) by their second birthday.
| Health Plan | Rate |
|---|---|
| SelectHealth | 84% |
| Regence BCBS | 80% |
| United | 76% |
| National Average | 74% |
| Aetna Health | 60% |
| Cigna | 21% |
| EMI | 19% |
| Aetna Life | Not Reported |
| Humana | Small Denominator |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Childhood Immunization Status.
Well-Child Visits in the first 15 Months of Life – 6 or more visits
Assesses children who turned 15 months old during the measurement year and had 6 well-child visits with a primary care physician during their first 15 months of life.
| Health Plan | Rate |
|---|---|
| SelectHealth | 81% |
| National Average | 80% |
| Regence BCBS | 77% |
| Cigna | 76% |
| Aetna Life | 73% |
| Aetna Health | 73% |
| EMI | 69% |
| United | 61% |
| Humana | Small Denominator |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Child and Adolescent Well-Care Visits.
Pediatric Care
Appropriate Treatment for Children With Upper Respiratory Infection
Assesses children 3 months–18 years of age who were given a diagnosis of upper respiratory infection (URI) and were not dispensed an antibiotic prescription. A higher rate indicates appropriate treatment of children with URI (i.e., the proportion for whom antibiotics were not prescribed).
| Health Plan | Rate |
|---|---|
| Aetna Life | 94% |
| Aetna Health | 93% |
| United | 93% |
| SelectHealth | 93% |
| Cigna | 93% |
| EMI | 91% |
| Regence BCBS | 91% |
| National Average | 90% |
| Humana | Small Denominator |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Appropriate Treatment for Children With Upper Respiratory Infection.
Children and Adolescents Access To PCP – 12-24 Months
Assesses children and young adults 12-24 months of age who had a visit with a primary care practitioner (PCP).
| Health Plan | Rate |
|---|---|
| SelectHealth | 98% |
| Cigna | 98% |
| National Average | 98% |
| Regence BCBS | 98% |
| United | 97% |
| Aetna Life | 97% |
| Aetna Health | 95% |
| EMI | 95% |
| Humana | Small Denominator |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Children and Adolescents’ Access to Primary Care Practitioners.
Immunizations for Adolescents – Combination 2
Assesses adolescents 13 years of age who had one dose of meningococcal vaccine, one Tdap vaccine and the complete human papillomavirus vaccine series by their 13th birthday.
| Health Plan | Rate |
|---|---|
| SelectHealth | 28% |
| National Average | 25% |
| Regence BCBS | 24% |
| Aetna Health | 19% |
| United | 18% |
| Humana | 18% |
| Aetna Life | 16% |
| Cigna | 14% |
| EMI | 12% |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Immunizations for Adolescents.
Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents – BMI percentile – Total
Assesses children and adolescents 3-17 years of age who had an outpatient visit with a primary care practitioner or OB/GYN during the measurement year and had evidence of Body mass index (BMI) percentile documentation.
| Health Plan | Rate |
|---|---|
| SelectHealth | 89% |
| Aetna Health | 72% |
| Aetna Life | 67% |
| National Average | 66% |
| United | 64% |
| Regence BCBS | 62% |
| Humana | 57% |
| Cigna | 5% |
| EMI | 3% |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents.
Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life
Assesses children 3-6 years of age who received one or more well-child visits with a primary care practitioner during the measurement year.
| Health Plan | Rate |
|---|---|
| National Average | 77% |
| SelectHealth | 71% |
| Regence BCBS | 68% |
| Aetna Life | 65% |
| Cigna | 65% |
| United | 65% |
| Aetna Health | 64% |
| EMI | 63% |
| Humana | 56% |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Child and Adolescent Well-Care Visits.
Adult Care
Adult Access to Preventive and Ambulatory Health Services – Total
The percentage of members 20 years and older who had an ambulatory or preventive care visit during the measurement year.
| Healthcare Plan | Value |
|---|---|
| Aetna Health | 95% |
| SelectHealth | 94% |
| National Average | 94% |
| Regence BCBS | 94% |
| United | 94% |
| Aetna Life | 94% |
| Cigna | 94% |
| Humana | 92% |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Adults’ Access to Preventive and Ambulatory Health Services.
Antidepressant Medication Management – Effective Acute Phase Treatment
Assesses adults 18 years of age and older with a diagnosis of major depression who were newly treated with antidepressant medication and remained on an antidepressant medication for at least 84 days (12 weeks).
| Health Plan | Rate |
|---|---|
| Regence BCBS | 72% |
| Aetna Life | 70% |
| National Average | 69% |
| EMI | 68% |
| SelectHealth | 67% |
| Cigna | 65% |
| Aetna Health | 64% |
| United | 62% |
| Humana | Small Denominator |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Antidepressant Medication Management.
Antidepressant Medication Management – Effective Continuation Phase Treatment
Assesses adults 18 years of age and older with a diagnosis of major depression who were newly treated with antidepressant medication and remained on an antidepressant medication for at least 84 days (12 weeks).
| Health Plan | Rate |
|---|---|
| Aetna Life | 58% |
| Regence BCBS | 54% |
| EMI | 53% |
| National Average | 53% |
| Aetna Health | 52% |
| SelectHealth | 51% |
| Cigna | 47% |
| United | 45% |
| Humana | Small Denominator |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Antidepressant Medication Management.
Breast Cancer Screening
Assesses women 50–74 years of age who had at least one mammogram to screen for breast cancer in the past two years.
| Health Plan | Rate |
|---|---|
| Humana | 75% |
| National Average | 72% |
| SelectHealth | 70% |
| Regence BCBS | 66% |
| Cigna | 64% |
| United | 64% |
| EMI | 62% |
| Aetna Health | 61% |
| Aetna Life | 61% |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Breast Cancer Screening.
Cervical Cancer Screening
Assesses women 21–64 years of age who were screened for cervical cancer using either of the following criteria:
- Women age 21–64 who had cervical cytology performed every 3 years.
- Women age 30–64 who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years.
| Health Plan | Rate |
|---|---|
| National Average | 74% |
| United | 73% |
| SelectHealth | 70% |
| Regence BCBS | 70% |
| Humana | 69% |
| Aetna Health | 65% |
| Aetna Life | 64% |
| Cigna | 62% |
| EMI | 57% |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Cervical Cancer Screening.
Comprehensive Diabetes Care – HbA1c Testing
Assesses adults 18–75 years of age with diabetes (type 1 and type 2) who had Hemoglobin A1c (HbA1c) testing.
| Health Plan | Rate |
|---|---|
| SelectHealth | 94% |
| Humana | 92% |
| Regence BCBS | 91% |
| United | 91% |
| National Average_ | 91% |
| EMI | 91% |
| Cigna | 90% |
| Aetna Health | 87% |
| Aetna Life | 86% |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Comprehensive Diabetes Care.
Comprehensive Diabetes Care – Eye Exams
Assesses adults 18–75 years of age with diabetes (type 1 and type 2) who had an eye exam (retinal) performed.
| Health Plan | Rate |
|---|---|
| SelectHealth | 67% |
| Aetna Health | 61% |
| Regence BCBS | 59% |
| National Average | 53% |
| Aetna Life | 49% |
| EMI | 48% |
| United | 46% |
| Humana | 36% |
| Cigna | 35% |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Comprehensive Diabetes Care.
Controlling High Blood Pressure
Assesses adults 18–85 years of age with a diagnosis of hypertension and whose blood pressure was adequately controlled based on the following criteria:
- Adults 18-59 years of age whose blood pressure was <140/90 mm Hg.
- Adults 60-85 years of age, with a diagnosis of diabetes, whose blood pressure was <140/90 mm Hg.
- Adults 60-85 years of age, without a diagnosis of diabetes, whose blood pressure was <150/90 mm Hg.
| Health Plan | Rate |
|---|---|
| Humana | 76% |
| SelectHealth | 68% |
| Regence BCBS | 62% |
| United | 60% |
| Aetna Health | 60% |
| National Average | 55% |
| Aetna Life | 8% |
| Cigna | 5% |
| EMI | 2% |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Controlling High Blood Pressure.
Follow-Up After Hospitalization For Mental Illness – 7 days – Total
Assesses adults and children 6 years of age and older who were hospitalized for treatment of selected mental illness or intentional self-harm and had an outpatient visit, an intensive outpatient encounter or a partial hospitalization with a mental health practitioner. The measure identifies the percentage of members who received follow-up within 7 days of discharge.
| Healthcare Plan | Value |
|---|---|
| Cigna | 50% |
| United | 49% |
| SelectHealth | 45% |
| National Average | 44% |
| Aetna Life | 44% |
| Regence BCBS | 43% |
| Aetna Health | 40% |
| EMI | 29% |
| Humana | Small Denominator |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Follow-Up After Hospitalization for Mental Illness.
Follow-Up After Hospitalization For Mental Illness – 30 days – Total
Assesses adults and children 6 years of age and older who were hospitalized for treatment of selected mental illness or intentional self-harm and had an outpatient visit, an intensive outpatient encounter or a partial hospitalization with a mental health practitioner. The measure identifies the percentage of members who received follow-up within 30 days of discharge.
| Healthcare Plan | Value |
|---|---|
| Cigna | 72% |
| United | 68% |
| SelectHealth | 67% |
| Aetna Life | 67% |
| Aetna Health | 66% |
| National Average | 66% |
| Regence BCBS | 62% |
| EMI | 60% |
| Humana | Small Denominator |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Follow-Up After Hospitalization for Mental Illness.
Initiation and Engagement of Alcohol and Other Drug Dependence Treatment – Initiation of AOD – Total
Assesses adults and adolescents 13 years of age and older with a new episode of alcohol or other drug (AOD) dependence who initiated treatment through an inpatient AOD admission, outpatient visit, intensive outpatient encounter or partial hospitalization, telehealth or medication-assisted treatment (MAT) within 14 days of diagnosis.
| Healthcare Plan | Value |
|---|---|
| SelectHealth | 48% |
| United | 43% |
| Cigna | 41% |
| Aetna Health | 40% |
| Aetna Life | 39% |
| EMI | 36% |
| National Average | 36% |
| Regence BCBS | 35% |
| Humana | Small Denominator |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment.
Initiation and Engagement of Alcohol and Other Drug Dependence Treatment – Engagement of AOD – Total
Assesses adults and adolescents 13 years of age and older with a new episode of alcohol or other drug (AOD) dependence who initiated treatment and had two or more additional AOD services or MAT within 34 days of the initiation visit.
| Healthcare Plan | Value |
|---|---|
| United | 18% |
| SelectHealth | 17% |
| Cigna | 16% |
| EMI | 14% |
| Aetna Life | 14% |
| National Average | 13% |
| Regence BCBS | 12% |
| Aetna Health | 12% |
| Humana | Small Denominator |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment.
Use of Imaging Studies for Low Back Pain
Assesses adults 18–50 with a primary diagnosis of low back pain who did not have an imaging study (plain X-ray, MRI or CT scan) within 28 days of the diagnosis (a higher score indicates better performance).
| Health Plan | Rate |
|---|---|
| United | 82% |
| EMI | 82% |
| Cigna | 80% |
| Aetna Life | 80% |
| Regence BCBS | 76% |
| National Average | 76% |
| SelectHealth | 76% |
| Humana | Small Denominator |
| Aetna Health | 75% |
For more information, please visit the National Committee for Quality Assurance (NCQA) website for Use of Imaging Studies for Low Back Pain.