Health Plan Quality of Care Report for Utah Commercial HMOs, Medicaid & CHIP Health Plans (HEDIS)


To determine how health plans in Utah are performing compared to other health plans in the nation, State averages are compared with National averages.

  • In all cases, breast cancer screening rates were below national averages.
  • Nearly 90% of confirmed diabetics receive an annual HbA1c screening.
  • Utah falls behind in performing chlamydia screenings. No health plan met the national average in their respective category.

  • Many health plans failed to meet the national averages in their respective categories for "six or more well-child visits in the first 15 months of life".

In many cases, variation in HEDIS rates across health plans may not actually reflect variation in access or quality of care. This can occur when health plans elect to use different measurement methods relative to their peers, such as choosing (or not choosing) to augment administrative data with chart reviews. In other cases, some health plans may have used (or only had access to) lower quality data and information systems to tabulate the required HEDIS rates.

The National Committee for Quality Assurance (NCQA) releases an annual report containing nationwide HEDIS figures aggregated from participating health plans. The annual report is available on the NCQA website.