Quality report cards

Wouldn't it be great to compare the experiences people have in different health plans? You can.
The National Committee for Quality Assurance is an independent, nonprofit group. Their goal is to improve health care quality. They created a set of measures called the Healthcare Effectiveness Data and Information Set (HEDIS®). These are used to rate health plans. They rate quality of care, access to care and member satisfaction. More than 90% of America’s health plans use these measures.

The measures address many important health issues, including:

• Asthma medication use
• Persistence of beta-blocker treatment after a heart attack
• Control of high blood pressure
• Comprehensive diabetes care
• Breast and cervical cancer screening
• Colorectal cancer screening
• Antidepressant medication use
• Childhood immunization status

You can use HEDIS results as one of several tools available to help you evaluate and choose a health plan based on value, not just on cost. To learn more, visit the NCQA website.

Quality Report Cards are based on HEDIS data. Report cards rate the care and service people receive in health plans in different states. Not all states offer report cards.

The following are in PDF format 

Report cards include information on the following:

Access to care
How well did the plan provide access to needed care? What percentage of adults and children saw doctors for routine or preventive care such as immunizations against childhood diseases?

Prevention and screening
What percentage of members had health screenings?  Screenings for breast health, cervical and colorectal cancers should be done when recommended by your doctor.  This can help to catch problems early when they are easier to treat. 

Maternity care
What percentage of pregnant women had proper maternity care?

Treatment of acute and chronic illness
What percentage of members had treatment for acute and chronic conditions?  Diseases such as diabetes, high blood pressure and asthma need regular monitoring and treatment in order to stay healthy.  

Mental health
What percentage of members had treatment for mental illness and follow-up care?

Member satisfaction
How satisfied were members with the plan and the doctors in its network?