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2021 HEDIS® Results – Medicare HMO

HEDIS Accreditation Measure for Medicare Description Final HEDIS Final HEDIS HEDIS
Breast Cancer Screening The percentage of women 50 to 74 years of age who had a mammogram to screen for breast cancer. 64.32% 68.43% 68.23%
Colorectal Cancer Screening The percentage of members 50 to 75 years of age who had appropriate screening for colorectal cancer. 58.2% 67.85% 67.27%
Comprehensive Diabetes Care Eye Exam The percentage of members 18 to 75 years of age who had an eye screening for diabetic retinal disease and includes one of the following: a retinal or dilated eye exam by an eye care professional (optometrist or ophthalmologist) in the measurement year or a negative retinal or dilated eye exam (negative for retinopathy) by an eye care professional in the year prior to the measurement year. 49.73% 63.99% 65.12%
Comprehensive Diabetes Care HbA1c Poor Control (>9.0 percent; Lower is Better) The percentage of members 18 to 75 years of age whose last HbA1c test had a result of >9.0 percent during the measurement year. 27.03% 24.33% 25.47%
Comprehensive Diabetes Care HbA1c Testing The percentage of members 18 to 75 years of age who had an HbA1c test performed during the measurement year. 89.19% 93.43% 89.43%
Comprehensive Diabetes Care Medical Attention for Nephropathy The percentage of members 18 to 75 years of age who had a screening or monitoring test during the measurement year. 93.37% 95.86% 94.6%
Controlling High Blood Pressure (Total Rate) The percentage of members 18 to 85 years of age who had a diagnosis of hypertension (HTN) and whose blood pressure (BP) was adequately controlled during the measurement year. 59.12% 55.96% 59.49%
Flu Shots for Older Adults The percentage of members 65 years of age and older who received an influenza vaccination between July 1 of the measurement year and the date when the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey was completed. 72.0% 74.8% ND
Follow-Up After Hospitalization for Mental Illness (Seven-Day Rate) The percentage of discharges for members six years of age and older (hospitalized for specified mental illnesses) who had a follow-up visit with a mental health provider within seven days of discharge. 34.78% 28.57% 24.45%

 

Medical Assistance With Smoking Cessation (Advising Smokers to Quit) The percentage of members 18 years of age and older who currently smoke and responded via survey that they received advice from a doctor about quitting during the measurement year. 84.4% 83.9% ND
Persistence of Beta-Blocker Treatment After a Heart Attack The percentage of members 18 years of age and older during the measurement year who were hospitalized and discharged from July 1 of the year prior to the measurement year to June 30 of the measurement year with a diagnosis of acute myocardial infarction (AMI)/heart attack and who received persistent beta-blocker treatment for six months after discharge. 80.65% 96.67% 89.02%

HEDIS® is a registered trademark of the National Committee for Quality Assurance.

CAHPS® is a registered trademark of the Agency of Healthcare Research and Quality.

An Independent Licensee of the Blue Cross Blue Shield Association.