| Health Plan Employer Data & Information Set (HEDIS®[1]) is a set of standardized performance measures related to many important public health issues such as cancer, heart disease, smoking, asthma, and diabetes.
HEDIS® also includes a member satisfaction survey, the Consumer Assessment of Health Plans (CAHPS®[2]), which evaluates plan performance in areas such as customer service, access to care, and claims possessing.
HEDIS® is sponsored, supported, and maintained by the National Committee on Quality Assurance (NCQA). This is a non-profit organization committed to assessing, reporting on, and improving the quality of care provided by health plans.
HEDIS® allows health plans to develop meaningful information about the quality and value of care that members receive, and it provides health plans with measures upon which they can continuously improve.
A sample of HNE HEDIS® and CAHPS® rates compared to national averages published by NCQA in Quality Compass® 2006 are shown below. A full report may be obtained by calling HNE Member Services (413-787-4004 or 800-310-2835 Monday-Friday, 8 a.m.-5 p.m.)
Adolescent Immunizations
Protecting children from deadly diseases is a HNE goal. This measure calculates the percentage of adolescents who received all required doses of several vaccines by their 13th birthday.
HNE: 88%
National: 55%
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Appropriately Treating Children with Colds
Recent science has shown that the overuse of antibiotics has lead to stronger, more drug resistant infections. While the common cold (upper respiratory infection {URI}) is a frequent reason for children visiting the doctor’s office, studies do not show that antibiotics are an effective course of treatment. This measure shows the percent of children who did not receive an antibiotic for a URI.
HNE: 91%
National: 83%
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Breast Cancer Screening
This measure looks at women between the ages of 52 and 69 who received a mammogram in the past two years. With nearly 200,000 new cases of breast cancer reported each year, getting a mammogram annually is a woman’s best line of defense.
HNE: 82%
National: 72%
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Chlamydia Screening
The Centers for Disease Control and Prevention estimates that three million people are infected with chlamydia each year. Sexually active women between the ages of 16 and 25 should be screened to prevent pelvic inflammatory disease, infertility, and ectopic pregnancy. Most women who have chlamydia do not experience any symptoms, making regular screenings important. This measure shows the percent of women who were screened.
HNE: 42%
National: 34%
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Cervical Cancer Screening
Annually more than 10,000 women in the U.S. are diagnosed with invasive cervical cancer and nearly 4,000 die. Cervical cancer can be detected in its earliest stages by using a Pap test. Guidelines recommend women get a Pap test every 1 to 3 years depending on risk factors. The measure shows the percent of women who were tested.
HNE: 83%
National: 82%
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Diabetes Care
It is estimated that 19 million Americans have diabetes. Complications such as kidney disease and blindness can be prevented when early detection and interventions are applied. The HNE Diabetes Management Program seeks to improve the quality of life and health status of members with diabetes.
| Diabetes Care Measure |
HNE |
National |
| Checking eyes |
77% |
55% |
| Testing blood sugar |
92% |
88% |
| Checking cholesterol |
96% |
92% |
| Monitoring for kidney disease |
74% |
54% |
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Member Satisfaction Survey Results
HNE is always interested in how our members feel we are doing in delivering care and service. We do this through a standardized survey tool. The survey provides results in several key categories, which are listed in the table to the left. The survey helps us learn what our members say about the quality of their personal experience as members of HNE. Each members’ personal experience and satisfaction helps us improve the way we deliver care and service.
Member Satisfaction Survey Results
| Category Measured |
HNE |
National |
| Getting Needed Care |
82 |
80 |
| Getting Care Quickly |
84 |
80 |
| Courteous & Helpful Office Staff |
96 |
93 |
| Customer Service |
76 |
70 |
| Claims Processing |
93 |
89 |
| Rating of All Health Care |
80 |
78 |
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[1] HEDIS® and Quality Compass® are registered trademarks of the National Committee for Quality Assurance (NCQA).
[2] CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).
The source for data indicated above in Quality Compass™ 2006 and is used with permission from NCQA. Any analysis, interpretation, or conclusion based on these data is solely that of the authors, and NCQA specifically disclaims responsibility for any such analysis, interpretation, or conclusion. Quality Compass is a registered trademark of NCQA.
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