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2022 Horizon BCBSNJ HEDIS® results

2022 HEDIS® Results – HMO/POS Combined
HEDIS Accreditation Measure for HMO/POS Combined Description Final HEDIS 2022 Performance Rate Final HEDIS 2021 Performance Rate HEDIS 2022 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. 70.85% 71.91% ND*
Cervical Cancer Screening (Commercial) The percentage of women 21 to 64 years of age who were screened for cervical cancer using either of the following criteria: women 21 to 64 years of age who had cervical cytology performed every three years or women 30 to 64 years of age who had cervical cytology/human papillomavirus (HPV) co-testing performed every five years. 81.31% 76.8% ND*
Childhood Immunization – Combination 10 The percentage of children 2 years of age who had 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); four pneumococcal conjugate (PCV); one hepatitis A (HepA); two or three rotavirus (RV); and two influenza (flu) vaccines by their second birthday. The measure calculates a rate for each vaccine and three combination rates. 57.04 NA* ND*
Chlamydia Screening for Women – Total Rate The percentage of women 16 to 24 years of age who were identified as sexually active and who had at least one test for chlamydia during the measurement year. 60.69% 58.82% ND*
Colorectal Cancer Screening The percentage of members 50 to 75 years of age who had appropriate screening for colorectal cancer. 65.26% 64.75% ND*
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 included 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. 58.78% 54.15% ND*
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. 88.54% 86.59% ND*
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. 24.15% 35.37% ND*
Controlling High Blood Pressure The percentage of members 18 to 85 years of age who had a diagnosis of hypertension (HTN) and whose BP was adequately controlled during the measurement year. 65.12% 53.53% ND*
Flu Shots for Adults Ages 18 to 64 Years of Age (Survey measure) The percentage of members 50 to 64 years of age 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. 49.20% 54.29% 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. 58.92% 59.75% ND*

*The Childhood Immunization Combo 10 measure previously reflected Childhood Immunization Combo 2 in HEDIS 2021.

*The 2022 NJ State average is not determined.

2022 HEDIS Results – PPO/EPO
HEDIS Accreditation Measure for PPO Description Final HEDIS 2022 Performance Rate Final HEDIS 2021 Performance Rate HEDIS 2022 NJ State Average Performance Rate
Breast Cancer Screening The percentage of women 50 to 74 years of age who had a mammogram to screen for breast cancer. 68.50% 67.98% 68.17%
Cervical Cancer Screening (Commercial) The percentage of women 21 to 64 years of age who were screened for cervical cancer using either of the following criteria: women 21 to 64 years of age who had cervical cytology performed every three years or women 30 to 64 years of age who had cervical cytology/human papillomavirus (HPV) co-testing performed every five years. 73.52% 74.43% 72.94%
Childhood Immunization - Combination 10 The percentage of children 2 years of age who had 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); four pneumococcal conjugate (PCV); one hepatitis A (HepA); two or three rotavirus (RV); and two influenza (flu) vaccines by their second birthday. The measure calculates a rate for each vaccine and three combination rates. 54.26% NA* 45.97%
Chlamydia Screening for Women - Total Rate The percentage of women 16 to 24 years of age who were identified as sexually active and who had at least one test for chlamydia during the measurement year. 56.35% 51.86% 54.41%
Colorectal Cancer Screening The percentage of members 50 to 75 years of age who had appropriate screening for colorectal cancer. 60.44% 55.33% 63.07%
Comprehensive Diabetes Care Eye Exam The percentage of members 18 to 75 years 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. 46.96% 40.63% 43.71%
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. 90.27% 86.37% 89.86%
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. 30.90% 53.53% 31.79%
Controlling High Blood Pressure The percentage of members 18 to 85 years of age who had a diagnosis of hypertension (HTN) and whose BP was adequately controlled during the measurement year. 54.74% 46.72% 56.73%
Flu Shots for Adults Ages 18 to 64 Years of Age (Survey measure) The percentage of members 50 to 64 years of age 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. 47.14% 55.43% 53.38%
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. 51.09% 50.41% 53.89%

*The Childhood Immunization Combo 10 measure previously reflected Childhood Immunization Combo 2 in HEDIS 2021. Not applicable is reflected in HEDIS 2021.

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

An Independent Licensee of the Blue Cross Blue Shield Association.