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Highmark Health Options News:

2016 HEDIS Audit Results Demonstrate
Health Options’ 2015 Performance

In 2016, Highmark Health Options conducted its first HEDIS® (Healthcare Effectiveness Data and Information Set) audit to analyze the health plan’s 2015 performance measurements. These baseline results were benchmarked against the National Committee for Quality Assurance (NCQA) “Quality Compass” and demonstrated the following performance:

90th percentile

  1. Antidepressant medication management
  2. Nephropathy screening in diabetes

75th percentile

  1. Chlamydia screening in women
  2. Childhood immunization
  3. Human papilloma vaccination for female adolescents
  4. Nutrition and physical activity counseling for teens ages 12–17

These performance findings are used to guide our future quality improvement activities. Health Options is addressing multiple initiatives in 2017 to improve member health outcomes and its HEDIS scores. Based on the 2016 audit's findings, Health Options identified the following opportunities for improvement:

  1. Follow-up after hospitalization for mental illness
  2. Emergency room visit utilization
  3. Cervical cancer screening
  4. Comprehensive diabetes care
  5. Controlling high blood pressure
  6. Prenatal and postpartum care frequency and timeliness
  7. Adolescent and child well care
  8. Weight and nutrition counseling, ages 3–11; body mass index in all children

 

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