2021 HEDIS® Results – Medicare PPO
|HEDIS Accreditation Measure for Medicare||Description||Final HEDIS 2021 Performance Rate||Final HEDIS 2020 Performance Rate||HEDIS 2021 NJ State Average|
|Breast Cancer Screening||The percentage of women 50 to 74 years of age who had a mammogram to screen for breast cancer.||74.8%||75.78%||69.92%|
|Colorectal Cancer Screening||The percentage of members 50 to 75 years of age who had appropriate screening for colorectal cancer.||75.8%||85.05%||78.62%|
|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.||69.66%||78.59%||72.92%|
|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.||32.02%||22.87%||17.56%|
|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.||93.82%||96.35%||94.72%|
|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.||90.45%||97.08%||95.13%|
|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.||58.88%||63.43%||61.9%|
|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.||81.9%||70.9%||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.||0% Small denominator||50.00%||27.77%|
|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.||NA||NA||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.||NA Small Denominator||82.35%||89.3%|
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.