2013 Health Plan Quality of Care Report for Utah Commercial HMOs, Medicaid & CHIP Health Plans (HEDIS)
MyHealthCare in Utah MyHealthCare in Utah
 
Commercial HMO Measures:  Measures with a national average of 0.00% are first year measures. NCQA will publish benchmarks for these measures in 2014

Adults' access to preventive/ambulatory services
Percentage of members (20 - 44 years of age) that had an ambulatory or preventative care visit.
HMO NameRateData Collection Method
Altius 93.60% Administrative
SelectHealth 93.20% Administrative
NATIONAL AVERAGE: 93.40% STATE AVERAGE: 93.40%
 
Adults' access to preventive/ambulatory services
Percentage of members (45 - 64 years of age) that had an ambulatory or preventative care visit.
HMO NameRateData Collection Method
Altius 96.96% Administrative
SelectHealth 95.70% Administrative
NATIONAL AVERAGE: 95.84% STATE AVERAGE: 96.32%
 
Adults' access to preventive/ambulatory services
Percentage of members (65 years of age and older) that had an ambulatory or preventative care visit.
HMO NameRateData Collection Method
Altius 98.46% Administrative
SelectHealth 97.78% Administrative
NATIONAL AVERAGE: 97.27% STATE AVERAGE: 98.12%
 
Children's Access To Primary Care Providers
Percentage of children (12 - 19 years of age) who had a visit with a primary care practitioner.
HMO NameRateData Collection Method
Altius 84.77% Administrative
SelectHealth 85.05% Administrative
NATIONAL AVERAGE: 90.01% STATE AVERAGE: 84.90%
 
Children's Access To Primary Care Providers
Percentage of children (12 - 24 months of age) who had a visit with a primary care practitioner.
HMO NameRateData Collection Method
Altius 98.48% Administrative
SelectHealth 98.28% Administrative
NATIONAL AVERAGE: 97.94% STATE AVERAGE: 98.37%
 
Children's Access To Primary Care Providers
Percentage of children (25 months - 6 years of age) who had a visit with a primary care practitioner.
HMO NameRateData Collection Method
Altius 84.20% Administrative
SelectHealth 87.04% Administrative
NATIONAL AVERAGE: 92.31% STATE AVERAGE: 85.61%
 
Children's Access To Primary Care Providers
Percentage of children (7 - 11 years of age) who had a visit with a primary care practitioner.
HMO NameRateData Collection Method
Altius 81.27% Administrative
SelectHealth 82.45% Administrative
NATIONAL AVERAGE: 92.93% STATE AVERAGE: 81.85%
 

Immunizations for Adolescents
Percentage of adolescents who received one meningococcal vaccine on or between the member's 11th and 13th birthday.
HMO NameRateData Collection Method
Altius 65.49% Admin+Chart Review
SelectHealth 70.74% Admin+Chart Review
NATIONAL AVERAGE: 64.88% STATE AVERAGE: 68.11%
 
Immunizations for Adolescents
Percentage of adolescents who received one TDAP vaccine between the member's 10th and 13th birthday.
HMO NameRateData Collection Method
Altius 90.11% Admin+Chart Review
SelectHealth 90.69% Admin+Chart Review
NATIONAL AVERAGE: 78.17% STATE AVERAGE: 90.40%
 
Immunizations for Adolescents
Percentage of adolescents who received one meningococcal vaccine, and one TDAP between the members 10th and 13th birthdays.
HMO NameRateData Collection Method
Altius 64.18% Admin+Chart Review
SelectHealth 70.74% Admin+Chart Review
NATIONAL AVERAGE: 62.27% STATE AVERAGE: 67.46%
 
Human Papillomavirus Vaccine for Female Adolescents
Percentage of female adolescents (13 years of age) who had three doses of the HPV vaccine by their 13th birthday
HMO NameRateData Collection Method
Altius 11.24% Admin+Chart Review
SelectHealth 13.63% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 12.43%
 

Comprehensive Diabetes Care
Percentage of members with diabetes (18 - 75 years of age) who had an eye exam.
HMO NameRateData Collection Method
Altius 59.01% Admin+Chart Review
SelectHealth 63.69% Admin+Chart Review
NATIONAL AVERAGE: 55.70% STATE AVERAGE: 61.34%
 
Comprehensive Diabetes Care
Percentage of members with diabetes (18 - 75 years of age) who had their Hemoglobin A1c tested.
HMO NameRateData Collection Method
Altius 88.96% Admin+Chart Review
SelectHealth 93.43% Admin+Chart Review
NATIONAL AVERAGE: 89.76% STATE AVERAGE: 91.19%
 
Comprehensive Diabetes Care
Percentage of members with diabetes (18 - 75 years of age) who had their LDL-C level under control.
HMO NameRateData Collection Method
Altius 44.82% Admin+Chart Review
SelectHealth 52.01% Admin+Chart Review
NATIONAL AVERAGE: 47.70% STATE AVERAGE: 48.41%
 
Comprehensive Diabetes Care
Percentage of members with diabetes (18 - 75 years of age) who had their LDL-C screened.
HMO NameRateData Collection Method
Altius 75.68% Admin+Chart Review
SelectHealth 83.03% Admin+Chart Review
NATIONAL AVERAGE: 85.22% STATE AVERAGE: 79.35%
 
Comprehensive Diabetes Care
Percentage of members with diabetes (18 - 75 years of age) who have poor HbA1c control. (Lower Rate is Better)
HMO NameRateData Collection Method
Altius 26.58% Admin+Chart Review
SelectHealth 19.89% Admin+Chart Review
NATIONAL AVERAGE: 28.85% STATE AVERAGE: 23.23%
 
Comprehensive Diabetes Care
Percentage of members with diabetes (18 - 75 years of age) who had a blood pressure less than 140/90 Hg
HMO NameRateData Collection Method
Altius 72.30% Admin+Chart Review
SelectHealth 74.09% Admin+Chart Review
NATIONAL AVERAGE: 64.92% STATE AVERAGE: 73.19%
 
Comprehensive Diabetes Care
Percentage of members with diabetes (18 - 75 years of age) who had a test for diabetic nephropathy.
HMO NameRateData Collection Method
Altius 77.25% Admin+Chart Review
SelectHealth 88.32% Admin+Chart Review
NATIONAL AVERAGE: 83.70% STATE AVERAGE: 82.78%
 

Appropriate Testing for Children with Pharyngitis
Percentage of children (2 -18 years of age) who were diagnosed with pharyngitis, dispensed an antibiotic and received a group A streptococcus (strep) test for the episode.
HMO NameRateData Collection Method
Altius 82.96% Administrative
SelectHealth 88.73% Administrative
NATIONAL AVERAGE: 81.22% STATE AVERAGE: 85.84%
 
Appropriate Treatment for Children with Upper Respiratory Infection
Percentage of children (3 months - 18 years of age) who were given a diagnosis of upper respiratory infection and were not dispensed an antibiotic prescription.
HMO NameRateData Collection Method
Altius 85.19% Administrative
SelectHealth 88.73% Administrative
NATIONAL AVERAGE: 84.23% STATE AVERAGE: 86.95%
 
BMI Percentile for Children
The percentage of members (3 - 17 years of age) who had an outpatient visit and who had their BMI documented.
HMO NameRateData Collection Method
Altius 39.60% Admin+Chart Review
SelectHealth 72.02% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 55.81%
 
Nutrition Counseling for Children
The percentage of members (3 - 17 years of age) who had an outpatient visit and who had evidence of counseling for nutrition
HMO NameRateData Collection Method
Altius 36.73% Admin+Chart Review
SelectHealth 52.80% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 44.76%
 
Physical Activity Counseling for Children
The percentage of members (3 - 17 years of age) who had an outpatient visit and who had evidence of counseling for physical activity
HMO NameRateData Collection Method
Altius 35.84% Admin+Chart Review
SelectHealth 46.96% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 41.40%
 

Adolescent Well-Care Visit
Percentage of members (12 - 21 years of age) who had at least one comprehensive well-care visit.
HMO NameRateData Collection Method
Altius 29.01% Administrative
SelectHealth 33.18% Administrative
NATIONAL AVERAGE: 44.76% STATE AVERAGE: 31.09%
 
Well-child visits in the 3rd/4th/5th/& 6th yr of life
Percentage of children (3 - 6 years of age) who received one or more well-child visits.
HMO NameRateData Collection Method
Altius 56.38% Administrative
SelectHealth 64.62% Administrative
NATIONAL AVERAGE: 74.36% STATE AVERAGE: 60.50%
 
Well-Child Visits In The First 15 Months of Life
Percentage of children (less than 15 months old) that received at least six or more well-child visits.
HMO NameRateData Collection Method
Altius 71.07% Administrative
SelectHealth 78.28% Administrative
NATIONAL AVERAGE: 78.67% STATE AVERAGE: 74.67%
 

Childhood Immunization Status
Percentage of children that received four DTaP; three IPV; one MMR; two HiB; three hepatitis B; and one VZV vaccination on or before their second birthday.
HMO NameRateData Collection Method
Altius 81.39% Admin+Chart Review
SelectHealth 85.64% Admin+Chart Review
NATIONAL AVERAGE: 79.83% STATE AVERAGE: 83.51%
 
Childhood Immunization Status
Percentage of children that received four DTaP; three IPV; one MMR; two HiB; three hepatitis B; one VZV; and four pneumococcal conjugate vaccinations on or before their second birthday.
HMO NameRateData Collection Method
Altius 78.25% Admin+Chart Review
SelectHealth 82.97% Admin+Chart Review
NATIONAL AVERAGE: 77.05% STATE AVERAGE: 80.60%
 
Childhood Immunization Status
Percentage of children that received four DTaP vaccinations on or before their second birthday.
HMO NameRateData Collection Method
Altius 86.55% Admin+Chart Review
SelectHealth 89.29% Admin+Chart Review
NATIONAL AVERAGE: 87.75% STATE AVERAGE: 87.92%
 
Childhood Immunization Status
Percentage of children that received at least three hepatitis B vaccinations on or before their second birthday.
HMO NameRateData Collection Method
Altius 93.50% Admin+Chart Review
SelectHealth 93.67% Admin+Chart Review
NATIONAL AVERAGE: 89.50% STATE AVERAGE: 93.58%
 
Childhood Immunization Status
Percentage of children that received at least two HiB vaccinations on or before their second birthday.
HMO NameRateData Collection Method
Altius 93.72% Admin+Chart Review
SelectHealth 94.40% Admin+Chart Review
NATIONAL AVERAGE: 94.70% STATE AVERAGE: 94.06%
 
Childhood Immunization Status
Percentage of children that received at least one MMR vaccination on or before their second birthday.
HMO NameRateData Collection Method
Altius 91.70% Admin+Chart Review
SelectHealth 92.46% Admin+Chart Review
NATIONAL AVERAGE: 91.78% STATE AVERAGE: 92.08%
 
Childhood Immunization Status
Percentage of children that received at least four pneumococcal conjugate vaccinations on or before their second birthday.
HMO NameRateData Collection Method
Altius 85.43% Admin+Chart Review
SelectHealth 87.59% Admin+Chart Review
NATIONAL AVERAGE: 87.42% STATE AVERAGE: 86.50%
 
Childhood Immunization Status
Percentage of children that received at least one VZV vaccination on or before their second birthday.
HMO NameRateData Collection Method
Altius 91.70% Admin+Chart Review
SelectHealth 92.70% Admin+Chart Review
NATIONAL AVERAGE: 91.70% STATE AVERAGE: 92.20%
 
Childhood Immunization Status
Percentage of children that received at least three IPV vaccinations on or before their second birthday.
HMO NameRateData Collection Method
Altius 94.39% Admin+Chart Review
SelectHealth 94.16% Admin+Chart Review
NATIONAL AVERAGE: 93.14% STATE AVERAGE: 94.27%
 

Colorectal Cancer Screening
Percentage of members (51 - 80 years of age) who had appropriate screening for colorectal cancer.
HMO NameRateData Collection Method
Altius 71.76% Admin+Chart Review
SelectHealth 69.55% Admin+Chart Review
NATIONAL AVERAGE: 62.63% STATE AVERAGE: 70.65%
 
Use of Imaging Studies for Low Back Pain
Percentage of members with a primary diagnosis of low back pain who did not have an imaging study (X-ray, MRI, CT scan) within 28 days of the diagnosis.
HMO NameRateData Collection Method
Altius 78.02% Administrative
SelectHealth 75.30% Administrative
NATIONAL AVERAGE: 74.28% STATE AVERAGE: 76.65%
 
Controlling High Blood Pressure
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 (<140/90) during the measurement year.
HMO NameRateData Collection Method
Altius 67.34% Admin+Chart Review
SelectHealth 68.39% Admin+Chart Review
NATIONAL AVERAGE: 61.63% STATE AVERAGE: 67.86%
 
Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis
The percentage of adults (12 - 64 years of age) with a diagnosis of acute bronchitis who were not dispensed an antibiotic prescription
HMO NameRateData Collection Method
Altius 25.38% Administrative
SelectHealth 27.50% Administrative
NATIONAL AVERAGE: 22.26% STATE AVERAGE: 26.44%
 
Cholesterol Management for Patients With Cardiovascular Conditions
Percentage of members with cardiovascular conditions (18-75 years of age) whose LDL-C cholesterol level was under 100mg/dL.
HMO NameRateData Collection Method
Altius 65.26% Admin+Chart Review
SelectHealth 66.58% Admin+Chart Review
NATIONAL AVERAGE: 59.27% STATE AVERAGE: 65.92%
 
Cholesterol Management for Patients With Cardiovascular Conditions
Percentage of members with cardiovascular conditions (18-75 years of age) who had a cholesterol screening test.
HMO NameRateData Collection Method
Altius 83.74% Admin+Chart Review
SelectHealth 91.05% Admin+Chart Review
NATIONAL AVERAGE: 88.13% STATE AVERAGE: 87.39%
 
Adult BMI Assessment
The percentage of members (18 - 74 years of age) who had an outpatient visit and whose body mass index (BMI) was documented
HMO NameRateData Collection Method
Altius 79.70% Admin+Chart Review
SelectHealth 81.51% Admin+Chart Review
NATIONAL AVERAGE: 64.27% STATE AVERAGE: 80.60%
 

Follow-Up After Hospitalization for Mental Illness
The percentage of members (6 years of age and older) who were hospitalized for treatment of selected mental health disorders and who had an follow-up visit within 30 days
HMO NameRateData Collection Method
Altius 72.42% Administrative
SelectHealth 73.54% Administrative
NATIONAL AVERAGE: 75.42% STATE AVERAGE: 72.98%
 
Follow-Up After Hospitalization for Mental Illness
The percentage of members (6 years of age and older) who were hospitalized for treatment of selected mental health disorders and who had an follow-up visit within 7 days
HMO NameRateData Collection Method
Altius 55.41% Administrative
SelectHealth 51.00% Administrative
NATIONAL AVERAGE: 57.57% STATE AVERAGE: 53.20%
 

Use of Appropriate Medications for People With Asthma
Percentage of members (5 - 11 years of age) during the measurement year who were identified as having persistent asthma and who were appropriately prescribed medication.
HMO NameRateData Collection Method
Altius 94.16% Administrative
SelectHealth 97.80% Administrative
NATIONAL AVERAGE: 95.25% STATE AVERAGE: 95.98%
 
Use of Appropriate Medications for People With Asthma
Percentage of members (5 - 50 years of age) during the measurement year who were identified as having persistent asthma and who were appropriately prescribed medication.
HMO NameRateData Collection Method
Altius 92.22% Administrative
SelectHealth 93.90% Administrative
NATIONAL AVERAGE: 91.08% STATE AVERAGE: 93.06%
 
Use of Appropriate Medications for People With Asthma
Percentage of members (12 - 18 years of age) during the measurement year who were identified as having persistent asthma and who were appropriately prescribed medication.
HMO NameRateData Collection Method
Altius 92.72% Administrative
SelectHealth 93.60% Administrative
NATIONAL AVERAGE: 92.11% STATE AVERAGE: 93.15%
 
Persistence of Beta-Blocker Treatment After a Heart Attack
The percentage of members (18 years of age and older) who were hospitalized with a diagnosis of AMI and who received persistent beta-blocker treatment for 6 months after discharge
HMO NameRateData Collection Method
Altius 70.00% Administrative
SelectHealth 75.34% Administrative
NATIONAL AVERAGE: 83.03% STATE AVERAGE: 72.66%
 

Breast Cancer Screening
Percentage of women (40 - 69 years of age) who had a mammogram to screen for breast cancer.
HMO NameRateData Collection Method
Altius 64.80% Administrative
SelectHealth 65.29% Administrative
NATIONAL AVERAGE: 69.86% STATE AVERAGE: 65.04%
 
Cervical Cancer Screening
Percentage of women (21 - 64 years of age) who received one or more Pap tests to screen for cervical cancer.
HMO NameRateData Collection Method
Altius 69.72% Administrative
SelectHealth 72.85% Administrative
NATIONAL AVERAGE: 75.51% STATE AVERAGE: 71.28%
 
Chlamydia Screening in Women
Percentage of women (16 -24 years of age) who were identified as sexually active and who had at least one test for chlamydia during the measurement year.
HMO NameRateData Collection Method
Altius 27.55% Administrative
SelectHealth 27.25% Administrative
NATIONAL AVERAGE: 45.16% STATE AVERAGE: 27.40%
 
Prenatal and Postpartum care
Percentage of deliveries that had a postpartum visit on or between 21 and 56 days after delivery.
HMO NameRateData Collection Method
Altius 76.73% Admin+Chart Review
SelectHealth 83.56% Admin+Chart Review
NATIONAL AVERAGE: 80.22% STATE AVERAGE: 80.14%
 
Prenatal and Postpartum care
Percentage of deliveries that received a prenatal care visit in the first trimester or within 42 days of enrollment in the organization.
HMO NameRateData Collection Method
Altius 89.45% Admin+Chart Review
SelectHealth 96.80% Admin+Chart Review
NATIONAL AVERAGE: 89.70% STATE AVERAGE: 93.12%
 
 
Medicaid Measures:  Measures with a national average of 0.00% are first year measures. NCQA will publish benchmarks for these measures in 2014

Adults' access to preventive/ambulatory services
Percentage of members (20 - 44 years of age) that had an ambulatory or preventative care visit.
HMO NameRateData Collection Method
Healthy U 82.68% Administrative
Molina 83.51% Administrative
NATIONAL AVERAGE: 80.37% STATE AVERAGE: 83.09%
 
Adults' access to preventive/ambulatory services
Percentage of members (45 - 64 years of age) that had an ambulatory or preventative care visit.
HMO NameRateData Collection Method
Healthy U 87.57% Administrative
Molina 88.54% Administrative
NATIONAL AVERAGE: 86.54% STATE AVERAGE: 88.05%
 
Adults' access to preventive/ambulatory services
Percentage of members (65 years of age and older) that had an ambulatory or preventative care visit.
HMO NameRateData Collection Method
Healthy U 89.03% Administrative
Molina 89.22% Administrative
NATIONAL AVERAGE: 84.41% STATE AVERAGE: 89.12%
 
Children's Access To Primary Care Providers
Percentage of children (12 - 19 years of age) who had a visit with a primary care practitioner.
HMO NameRateData Collection Method
Healthy U 86.34% Administrative
Molina 89.38% Administrative
NATIONAL AVERAGE: 88.38% STATE AVERAGE: 87.85%
 
Children's Access To Primary Care Providers
Percentage of children (12 - 24 months of age) who had a visit with a primary care practitioner.
HMO NameRateData Collection Method
Healthy U 97.02% Administrative
Molina 96.93% Administrative
NATIONAL AVERAGE: 95.97% STATE AVERAGE: 96.97%
 
Children's Access To Primary Care Providers
Percentage of children (25 months - 6 years of age) who had a visit with a primary care practitioner.
HMO NameRateData Collection Method
Healthy U 84.32% Administrative
Molina 86.61% Administrative
NATIONAL AVERAGE: 88.32% STATE AVERAGE: 85.46%
 
Children's Access To Primary Care Providers
Percentage of children (7 - 11 years of age) who had a visit with a primary care practitioner.
HMO NameRateData Collection Method
Healthy U 88.01% Administrative
Molina 89.51% Administrative
NATIONAL AVERAGE: 89.88% STATE AVERAGE: 88.75%
 

Immunizations for Adolescents
Percentage of adolescents who received one meningococcal vaccine on or between the member's 11th and 13th birthday.
HMO NameRateData Collection Method
Healthy U 74.45% Admin+Chart Review
Molina 67.99% Admin+Chart Review
NATIONAL AVERAGE: 69.37% STATE AVERAGE: 71.21%
 
Immunizations for Adolescents
Percentage of adolescents who received one TDAP vaccine between the member's 10th and 13th birthday.
HMO NameRateData Collection Method
Healthy U 88.81% Admin+Chart Review
Molina 83.33% Admin+Chart Review
NATIONAL AVERAGE: 81.33% STATE AVERAGE: 86.07%
 
Immunizations for Adolescents
Percentage of adolescents who received one meningococcal vaccine, and one TDAP between the members 10th and 13th birthdays.
HMO NameRateData Collection Method
Healthy U 73.97% Admin+Chart Review
Molina 66.93% Admin+Chart Review
NATIONAL AVERAGE: 67.19% STATE AVERAGE: 70.45%
 
Human Papillomavirus Vaccine for Female Adolescents
Percentage of female adolescents (13 years of age) who had three doses of the HPV vaccine by their 13th birthday
HMO NameRateData Collection Method
Healthy U 10.45% Administrative
Molina 16.90% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 13.67%
 

Comprehensive Diabetes Care
Percentage of members with diabetes (18 - 75 years of age) who had an eye exam.
HMO NameRateData Collection Method
Healthy U 52.33% Admin+Chart Review
Molina 64.14% Admin+Chart Review
NATIONAL AVERAGE: 53.17% STATE AVERAGE: 58.23%
 
Comprehensive Diabetes Care
Percentage of members with diabetes (18 - 75 years of age) who had their Hemoglobin A1c tested.
HMO NameRateData Collection Method
Healthy U 83.05% Admin+Chart Review
Molina 89.66% Admin+Chart Review
NATIONAL AVERAGE: 82.98% STATE AVERAGE: 86.35%
 
Comprehensive Diabetes Care
Percentage of members with diabetes (18 - 75 years of age) who had their LDL-C level under control.
HMO NameRateData Collection Method
Healthy U 34.89% Admin+Chart Review
Molina 38.75% Admin+Chart Review
NATIONAL AVERAGE: 33.93% STATE AVERAGE: 36.82%
 
Comprehensive Diabetes Care
Percentage of members with diabetes (18 - 75 years of age) who had their LDL-C screened.
HMO NameRateData Collection Method
Healthy U 70.52% Admin+Chart Review
Molina 76.61% Admin+Chart Review
NATIONAL AVERAGE: 75.56% STATE AVERAGE: 73.56%
 
Comprehensive Diabetes Care
Percentage of members with diabetes (18 - 75 years of age) who have poor HbA1c control. (Lower Rate is Better)
HMO NameRateData Collection Method
Healthy U 40.29% Admin+Chart Review
Molina 30.77% Admin+Chart Review
NATIONAL AVERAGE: 44.63% STATE AVERAGE: 35.52%
 
Comprehensive Diabetes Care
Percentage of members with diabetes (18 - 75 years of age) who had a blood pressure less than 140/90 Hg
HMO NameRateData Collection Method
Healthy U 60.93% Admin+Chart Review
Molina 68.27% Admin+Chart Review
NATIONAL AVERAGE: 59.02% STATE AVERAGE: 64.59%
 
Comprehensive Diabetes Care
Percentage of members with diabetes (18 - 75 years of age) who had a test for diabetic nephropathy.
HMO NameRateData Collection Method
Healthy U 67.32% Admin+Chart Review
Molina 83.17% Admin+Chart Review
NATIONAL AVERAGE: 78.38% STATE AVERAGE: 75.24%
 

Appropriate Testing for Children with Pharyngitis
Percentage of children (2 -18 years of age) who were diagnosed with pharyngitis, dispensed an antibiotic and received a group A streptococcus (strep) test for the episode.
HMO NameRateData Collection Method
Healthy U 65.42% Administrative
Molina 72.39% Administrative
NATIONAL AVERAGE: 68.03% STATE AVERAGE: 68.90%
 
Appropriate Treatment for Children with Upper Respiratory Infection
Percentage of children (3 months - 18 years of age) who were given a diagnosis of upper respiratory infection and were not dispensed an antibiotic prescription.
HMO NameRateData Collection Method
Healthy U 92.66% Administrative
Molina 90.14% Administrative
NATIONAL AVERAGE: 85.08% STATE AVERAGE: 91.39%
 
Lead Screening in Children
Percentage of children (2 years of age) who had one or more test for lead poisoning by their 2nd birthday.
HMO NameRateData Collection Method
Healthy U 27.29% Administrative
Molina 26.16% Admin+Chart Review
NATIONAL AVERAGE: 67.49% STATE AVERAGE: 26.72%
 

Adolescent Well-Care Visit
Percentage of members (12 - 21 years of age) who had at least one comprehensive well-care visit.
HMO NameRateData Collection Method
Healthy U 41.85% Admin+Chart Review
Molina 41.67% Admin+Chart Review
NATIONAL AVERAGE: 49.69% STATE AVERAGE: 41.75%
 
Well-child visits in the 3rd/4th/5th/& 6th yr of life
Percentage of children (3 - 6 years of age) who received one or more well-child visits.
HMO NameRateData Collection Method
Healthy U 59.37% Admin+Chart Review
Molina 63.19% Admin+Chart Review
NATIONAL AVERAGE: 72.00% STATE AVERAGE: 61.28%
 
Well-Child Visits In The First 15 Months of Life
Percentage of children (less than 15 months old) that received at least six or more well-child visits.
HMO NameRateData Collection Method
Healthy U 43.55% Admin+Chart Review
Molina 60.88% Admin+Chart Review
NATIONAL AVERAGE: 63.65% STATE AVERAGE: 52.21%
 

Childhood Immunization Status
Percentage of children that received four DTaP; three IPV; one MMR; two HiB; three hepatitis B; and one VZV vaccination on or before their second birthday.
HMO NameRateData Collection Method
Healthy U 78.35% Admin+Chart Review
Molina 80.09% Admin+Chart Review
NATIONAL AVERAGE: 75.74% STATE AVERAGE: 79.21%
 
Childhood Immunization Status
Percentage of children that received four DTaP; three IPV; one MMR; two HiB; three hepatitis B; one VZV; and four pneumococcal conjugate vaccinations on or before their second birthday.
HMO NameRateData Collection Method
Healthy U 75.18% Admin+Chart Review
Molina 74.54% Admin+Chart Review
NATIONAL AVERAGE: 72.08% STATE AVERAGE: 74.85%
 
Childhood Immunization Status
Percentage of children that received four DTaP vaccinations on or before their second birthday.
HMO NameRateData Collection Method
Healthy U 82.73% Admin+Chart Review
Molina 81.25% Admin+Chart Review
NATIONAL AVERAGE: 80.95% STATE AVERAGE: 81.99%
 
Childhood Immunization Status
Percentage of children that received at least three hepatitis B vaccinations on or before their second birthday.
HMO NameRateData Collection Method
Healthy U 88.08% Admin+Chart Review
Molina 90.97% Admin+Chart Review
NATIONAL AVERAGE: 89.51% STATE AVERAGE: 89.52%
 
Childhood Immunization Status
Percentage of children that received at least two HiB vaccinations on or before their second birthday.
HMO NameRateData Collection Method
Healthy U 93.43% Admin+Chart Review
Molina 91.90% Admin+Chart Review
NATIONAL AVERAGE: 92.01% STATE AVERAGE: 92.66%
 
Childhood Immunization Status
Percentage of children that received at least one MMR vaccination on or before their second birthday.
HMO NameRateData Collection Method
Healthy U 92.70% Admin+Chart Review
Molina 89.58% Admin+Chart Review
NATIONAL AVERAGE: 91.60% STATE AVERAGE: 91.14%
 
Childhood Immunization Status
Percentage of children that received at least four pneumococcal conjugate vaccinations on or before their second birthday.
HMO NameRateData Collection Method
Healthy U 82.00% Admin+Chart Review
Molina 78.94% Admin+Chart Review
NATIONAL AVERAGE: 80.07% STATE AVERAGE: 80.46%
 
Childhood Immunization Status
Percentage of children that received at least one VZV vaccination on or before their second birthday.
HMO NameRateData Collection Method
Healthy U 90.75% Admin+Chart Review
Molina 89.58% Admin+Chart Review
NATIONAL AVERAGE: 91.10% STATE AVERAGE: 90.16%
 
Childhood Immunization Status
Percentage of children that received at least three IPV vaccinations on or before their second birthday.
HMO NameRateData Collection Method
Healthy U 90.75% Admin+Chart Review
Molina 91.44% Admin+Chart Review
NATIONAL AVERAGE: 91.61% STATE AVERAGE: 91.09%
 

Use of Imaging Studies for Low Back Pain
Percentage of members with a primary diagnosis of low back pain who did not have an imaging study (X-ray, MRI, CT scan) within 28 days of the diagnosis.
HMO NameRateData Collection Method
Healthy U 74.07% Administrative
Molina 75.76% Administrative
NATIONAL AVERAGE: 75.55% STATE AVERAGE: 74.91%
 
Controlling High Blood Pressure
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 (<140/90) during the measurement year.
HMO NameRateData Collection Method
Healthy U 0.00% Not Reported
Molina 56.49% Admin+Chart Review
NATIONAL AVERAGE: 56.36% STATE AVERAGE: 28.24%
 
Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis
The percentage of adults (12 - 64 years of age) with a diagnosis of acute bronchitis who were not dispensed an antibiotic prescription
HMO NameRateData Collection Method
Healthy U 42.24% Administrative
Molina 31.45% Administrative
NATIONAL AVERAGE: 24.22% STATE AVERAGE: 36.84%
 
Cholesterol Management for Patients With Cardiovascular Conditions
Percentage of members with cardiovascular conditions (18-75 years of age) whose LDL-C cholesterol level was under 100mg/dL.
HMO NameRateData Collection Method
Healthy U 0.00% Not Reported
Molina 47.52% Admin+Chart Review
NATIONAL AVERAGE: 41.37% STATE AVERAGE: 23.76%
 
Cholesterol Management for Patients With Cardiovascular Conditions
Percentage of members with cardiovascular conditions (18-75 years of age) who had a cholesterol screening test.
HMO NameRateData Collection Method
Healthy U 53.14% Administrative
Molina 80.20% Admin+Chart Review
NATIONAL AVERAGE: 81.62% STATE AVERAGE: 66.67%
 

Use of Appropriate Medications for People With Asthma
Percentage of members (5 - 11 years of age) during the measurement year who were identified as having persistent asthma and who were appropriately prescribed medication.
HMO NameRateData Collection Method
Healthy U 90.98% Administrative
Molina 89.83% Administrative
NATIONAL AVERAGE: 89.65% STATE AVERAGE: 90.40%
 
Use of Appropriate Medications for People With Asthma
Percentage of members (5 - 50 years of age) during the measurement year who were identified as having persistent asthma and who were appropriately prescribed medication.
HMO NameRateData Collection Method
Healthy U 81.99% Administrative
Molina 87.05% Administrative
NATIONAL AVERAGE: 83.88% STATE AVERAGE: 84.51%
 
Use of Appropriate Medications for People With Asthma
Percentage of members (12 - 18 years of age) during the measurement year who were identified as having persistent asthma and who were appropriately prescribed medication.
HMO NameRateData Collection Method
Healthy U 88.41% Administrative
Molina 93.16% Administrative
NATIONAL AVERAGE: 85.59% STATE AVERAGE: 90.78%
 

Breast Cancer Screening
Percentage of women (40 - 69 years of age) who had a mammogram to screen for breast cancer.
HMO NameRateData Collection Method
Healthy U 45.06% Administrative
Molina 48.86% Administrative
NATIONAL AVERAGE: 51.82% STATE AVERAGE: 46.96%
 
Cervical Cancer Screening
Percentage of women (21 - 64 years of age) who received one or more Pap tests to screen for cervical cancer.
HMO NameRateData Collection Method
Healthy U 45.33% Administrative
Molina 63.81% Admin+Chart Review
NATIONAL AVERAGE: 64.51% STATE AVERAGE: 54.56%
 
Chlamydia Screening in Women
Percentage of women (16 -24 years of age) who were identified as sexually active and who had at least one test for chlamydia during the measurement year.
HMO NameRateData Collection Method
Healthy U 21.22% Administrative
Molina 38.50% Administrative
NATIONAL AVERAGE: 57.10% STATE AVERAGE: 29.85%
 
Chlamydia Screening in Women
Percentage of women (16 -20 years of age) who were identified as sexually active and who had at least one test for chlamydia during the measurement year.
HMO NameRateData Collection Method
Healthy U 19.52% Administrative
Molina 34.29% Administrative
NATIONAL AVERAGE: 53.50% STATE AVERAGE: 26.90%
 
Chlamydia Screening in Women
Percentage of women (21-24 years of age) who were identified as sexually active and who had at least one test for chlamydia during the measurement year.
HMO NameRateData Collection Method
Healthy U 23.18% Administrative
Molina 43.42% Administrative
NATIONAL AVERAGE: 63.66% STATE AVERAGE: 33.29%
 
Prenatal and Postpartum care
Percentage of deliveries that had a postpartum visit on or between 21 and 56 days after delivery.
HMO NameRateData Collection Method
Healthy U 48.64% Administrative
Molina 69.62% Admin+Chart Review
NATIONAL AVERAGE: 63.05% STATE AVERAGE: 59.13%
 
Prenatal and Postpartum care
Percentage of deliveries that received a prenatal care visit in the first trimester or within 42 days of enrollment in the organization.
HMO NameRateData Collection Method
Healthy U 18.38% Administrative
Molina 79.84% Admin+Chart Review
NATIONAL AVERAGE: 82.93% STATE AVERAGE: 49.10%
 
 
CHIP Measures:  Measures with a national average of 0.00% are first year measures. NCQA will publish benchmarks for these measures in 2014

Children's Access To Primary Care Providers
Percentage of children (12 - 19 years of age) who had a visit with a primary care practitioner.
HMO NameRateData Collection Method
Molina 88.01% Administrative
SelectHealth 90.04% Administrative
NATIONAL AVERAGE: 88.38% STATE AVERAGE: 89.02%
 
Children's Access To Primary Care Providers
Percentage of children (12 - 24 months of age) who had a visit with a primary care practitioner.
HMO NameRateData Collection Method
Molina 98.69% Administrative
SelectHealth 100.00% Administrative
NATIONAL AVERAGE: 95.97% STATE AVERAGE: 99.34%
 
Children's Access To Primary Care Providers
Percentage of children (25 months - 6 years of age) who had a visit with a primary care practitioner.
HMO NameRateData Collection Method
Molina 86.69% Administrative
SelectHealth 88.64% Administrative
NATIONAL AVERAGE: 88.32% STATE AVERAGE: 87.66%
 
Children's Access To Primary Care Providers
Percentage of children (7 - 11 years of age) who had a visit with a primary care practitioner.
HMO NameRateData Collection Method
Molina 87.73% Administrative
SelectHealth 86.41% Administrative
NATIONAL AVERAGE: 89.88% STATE AVERAGE: 87.07%
 

Immunizations for Adolescents
Percentage of adolescents who received one meningococcal vaccine on or between the member's 11th and 13th birthday.
HMO NameRateData Collection Method
Molina 67.22% Admin+Chart Review
SelectHealth 63.54% Admin+Chart Review
NATIONAL AVERAGE: 69.37% STATE AVERAGE: 65.37%
 
Immunizations for Adolescents
Percentage of adolescents who received one TDAP vaccine between the member's 10th and 13th birthday.
HMO NameRateData Collection Method
Molina 83.97% Admin+Chart Review
SelectHealth 92.71% Admin+Chart Review
NATIONAL AVERAGE: 81.33% STATE AVERAGE: 88.34%
 
Immunizations for Adolescents
Percentage of adolescents who received one meningococcal vaccine, and one TDAP between the members 10th and 13th birthdays.
HMO NameRateData Collection Method
Molina 66.03% Admin+Chart Review
SelectHealth 63.54% Admin+Chart Review
NATIONAL AVERAGE: 67.19% STATE AVERAGE: 64.78%
 
Human Papillomavirus Vaccine for Female Adolescents
The percentage of female adolescents 13 years of age who had three doses of the human papillomavirus (HPV) vaccine by their 13th birthday
HMO NameRateData Collection Method
Molina 16.96% Admin+Chart Review
SelectHealth 15.33% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 16.14%
 

Appropriate Testing for Children with Pharyngitis
Percentage of children (2 -18 years of age) who were diagnosed with pharyngitis, dispensed an antibiotic and received a group A streptococcus (strep) test for the episode.
HMO NameRateData Collection Method
Molina 70.54% Administrative
SelectHealth 82.41% Administrative
NATIONAL AVERAGE: 68.03% STATE AVERAGE: 76.47%
 
Appropriate Treatment for Children with Upper Respiratory Infection
Percentage of children (3 months - 18 years of age) who were given a diagnosis of upper respiratory infection and were not dispensed an antibiotic prescription.
HMO NameRateData Collection Method
Molina 86.90% Administrative
SelectHealth 86.22% Administrative
NATIONAL AVERAGE: 85.08% STATE AVERAGE: 86.55%
 
Lead Screening in Children
Percentage of members (2 years of age) who had one or more blood tests for lead poisoning by their second birthday.
HMO NameRateData Collection Method
Molina 19.31% Admin+Chart Review
SelectHealth 11.07% Administrative
NATIONAL AVERAGE: 67.49% STATE AVERAGE: 15.19%
 

Adolescent Well-Care Visit
Percentage of members (12 - 21 years of age) who had at least one comprehensive well-care visit.
HMO NameRateData Collection Method
Molina 36.51% Admin+Chart Review
SelectHealth 40.88% Administrative
NATIONAL AVERAGE: 49.69% STATE AVERAGE: 38.69%
 
Well-child visits in the 3rd/4th/5th/& 6th yr of life
Percentage of children (3 - 6 years of age) who received one or more well-child visits.
HMO NameRateData Collection Method
Molina 60.61% Admin+Chart Review
SelectHealth 61.55% Administrative
NATIONAL AVERAGE: 72.00% STATE AVERAGE: 61.07%
 
Well-Child Visits In The First 15 Months of Life
Percentage of children (less than 15 months old) that received at least six or more well-child visits.
HMO NameRateData Collection Method
Molina 72.95% Admin+Chart Review
SelectHealth 69.23% Administrative
NATIONAL AVERAGE: 63.65% STATE AVERAGE: 71.09%
 

Childhood Immunization Status
Percentage of children that received four DTaP; three IPV; one MMR; two HiB; three hepatitis B; and one VZV vaccination on or before their second birthday.
HMO NameRateData Collection Method
Molina 82.83% Admin+Chart Review
SelectHealth 81.11% Admin+Chart Review
NATIONAL AVERAGE: 75.74% STATE AVERAGE: 81.97%
 
Childhood Immunization Status
Percentage of children that received four DTaP; three IPV; one MMR; two HiB; three hepatitis B; one VZV; and four pneumococcal conjugate vaccinations on or before their second birthday.
HMO NameRateData Collection Method
Molina 80.69% Admin+Chart Review
SelectHealth 78.83% Admin+Chart Review
NATIONAL AVERAGE: 72.08% STATE AVERAGE: 79.75%
 
Childhood Immunization Status
Percentage of children that received four DTaP vaccinations on or before their second birthday.
HMO NameRateData Collection Method
Molina 85.41% Admin+Chart Review
SelectHealth 86.32% Admin+Chart Review
NATIONAL AVERAGE: 80.95% STATE AVERAGE: 85.86%
 
Childhood Immunization Status
Percentage of children that received at least three hepatitis B vaccinations on or before their second birthday.
HMO NameRateData Collection Method
Molina 93.13% Admin+Chart Review
SelectHealth 92.51% Admin+Chart Review
NATIONAL AVERAGE: 89.51% STATE AVERAGE: 92.82%
 
Childhood Immunization Status
Percentage of children that received at least two HiB vaccinations on or before their second birthday.
HMO NameRateData Collection Method
Molina 93.99% Admin+Chart Review
SelectHealth 94.14% Admin+Chart Review
NATIONAL AVERAGE: 92.01% STATE AVERAGE: 94.06%
 
Childhood Immunization Status
Percentage of children that received at least one MMR vaccination on or before their second birthday.
HMO NameRateData Collection Method
Molina 93.13% Admin+Chart Review
SelectHealth 92.18% Admin+Chart Review
NATIONAL AVERAGE: 91.60% STATE AVERAGE: 92.65%
 
Childhood Immunization Status
Percentage of children that received at least four pneumococcal conjugate vaccinations on or before their second birthday.
HMO NameRateData Collection Method
Molina 87.98% Admin+Chart Review
SelectHealth 87.62% Admin+Chart Review
NATIONAL AVERAGE: 80.07% STATE AVERAGE: 87.79%
 
Childhood Immunization Status
Percentage of children that received at least one VZV vaccination on or before their second birthday.
HMO NameRateData Collection Method
Molina 95.56% Admin+Chart Review
SelectHealth 92.18% Admin+Chart Review
NATIONAL AVERAGE: 91.10% STATE AVERAGE: 93.87%
 
Childhood Immunization Status
Percentage of children that received at least three IPV vaccinations on or before their second birthday.
HMO NameRateData Collection Method
Molina 93.56% Admin+Chart Review
SelectHealth 92.83% Admin+Chart Review
NATIONAL AVERAGE: 91.61% STATE AVERAGE: 93.19%
 

Use of Appropriate Medications for People With Asthma
Percentage of members (5 - 11 years of age) during the measurement year who were identified as having persistent asthma and who were appropriately prescribed medication.
HMO NameRateData Collection Method
Molina 97.87% Administrative
SelectHealth 94.12% Administrative
NATIONAL AVERAGE: 89.65% STATE AVERAGE: 95.99%
 
Use of Appropriate Medications for People With Asthma
Percentage of members (5 - 50 years of age) during the measurement year who were identified as having persistent asthma and who were appropriately prescribed medication.
HMO NameRateData Collection Method
Molina 94.74% Administrative
SelectHealth 96.30% Administrative
NATIONAL AVERAGE: 83.88% STATE AVERAGE: 95.52%
 
Use of Appropriate Medications for People With Asthma
Percentage of members (12 - 18 years of age) during the measurement year who were identified as having persistent asthma and who were appropriately prescribed medication.
HMO NameRateData Collection Method
Molina 91.67% Administrative
SelectHealth 98.25% Administrative
NATIONAL AVERAGE: 85.59% STATE AVERAGE: 94.95%
 
 
Commercial PPO Measures:  Measures with a national average of 0.00% are first year measures. NCQA will publish benchmarks for these measures in 2014

Adults' access to preventive/ambulatory services
Percentage of members (20 - 44 years of age) that had an ambulatory or preventative care visit.
HMO NameRateData Collection Method
UnitedHealthCare 92.83% Administrative
Aetna 94.04% Administrative
CIGNA 0.00% Not Reportable
Humana 83.57% Administrative
Regence 91.63% Administrative
NATIONAL AVERAGE: 92.73% STATE AVERAGE: 90.51%
 
Adults' access to preventive/ambulatory services
Percentage of members (45 - 64 years of age) that had an ambulatory or preventative care visit.
HMO NameRateData Collection Method
UnitedHealthCare 95.70% Administrative
Aetna 96.08% Administrative
CIGNA 0.00% Not Reportable
Humana 88.25% Administrative
Regence 94.85% Administrative
NATIONAL AVERAGE: 95.19% STATE AVERAGE: 93.71%
 
Adults' access to preventive/ambulatory services
Percentage of members (65 years of age and older) that had an ambulatory or preventative care visit.
HMO NameRateData Collection Method
UnitedHealthCare 96.15% Administrative
Aetna 79.76% Administrative
CIGNA 0.00% Not Reportable
Humana 97.53% Administrative
Regence 98.30% Administrative
NATIONAL AVERAGE: 96.25% STATE AVERAGE: 92.93%
 
Children's Access To Primary Care Providers
Percentage of children (12 - 19 years of age) who had a visit with a primary care practitioner.
HMO NameRateData Collection Method
UnitedHealthCare 80.94% Administrative
Aetna 82.23% Administrative
CIGNA 0.00% Administrative
Humana 74.36% Administrative
Regence 78.87% Administrative
NATIONAL AVERAGE: 87.60% STATE AVERAGE: 79.10%
 
Children's Access To Primary Care Providers
Percentage of children (12 - 24 months of age) who had a visit with a primary care practitioner.
HMO NameRateData Collection Method
UnitedHealthCare 97.31% Administrative
Aetna 97.38% Administrative
CIGNA 0.00% Not Reportable
Humana 94.57% Administrative
Regence 96.46% Administrative
NATIONAL AVERAGE: 97.00% STATE AVERAGE: 96.43%
 
Children's Access To Primary Care Providers
Percentage of children (25 months - 6 years of age) who had a visit with a primary care practitioner.
HMO NameRateData Collection Method
UnitedHealthCare 80.89% Administrative
Aetna 84.84% Administrative
CIGNA 0.00% Not Reportable
Humana 76.25% Administrative
Regence 82.40% Administrative
NATIONAL AVERAGE: 90.08% STATE AVERAGE: 81.09%
 
Children's Access To Primary Care Providers
Percentage of children (7 - 11 years of age) who had a visit with a primary care practitioner.
HMO NameRateData Collection Method
UnitedHealthCare 78.93% Administrative
Aetna 82.16% Administrative
CIGNA 0.00% Not Reportable
Humana 69.47% Administrative
Regence 78.52% Administrative
NATIONAL AVERAGE: 90.51% STATE AVERAGE: 77.26%
 

Immunizations for Adolescents
Percentage of adolescents who received one meningococcal vaccine on or between the member's 11th and 13th birthday.
HMO NameRateData Collection Method
UnitedHealthCare 57.55% Administrative
Aetna 55.12% Administrative
CIGNA 52.02% Administrative
Humana 41.54% Administrative
Regence 55.66% Administrative
NATIONAL AVERAGE: 57.05% STATE AVERAGE: 52.37%
 
Immunizations for Adolescents
Percentage of adolescents who received one TDAP vaccine between the member's 10th and 13th birthday.
HMO NameRateData Collection Method
UnitedHealthCare 76.76% Administrative
Aetna 73.55% Administrative
CIGNA 70.99% Administrative
Humana 59.84% Administrative
Regence 79.41% Administrative
NATIONAL AVERAGE: 69.92% STATE AVERAGE: 72.11%
 
Immunizations for Adolescents
Percentage of adolescents who received one meningococcal vaccine, and one TDAP between the members 10th and 13th birthdays.
HMO NameRateData Collection Method
UnitedHealthCare 55.48% Administrative
Aetna 52.98% Administrative
CIGNA 50.52% Administrative
Humana 40.05% Administrative
Regence 54.64% Administrative
NATIONAL AVERAGE: 54.26% STATE AVERAGE: 50.73%
 
Human Papillomavirus Vaccine for Female Adolescents
Percentage of female adolescents 13 years of age who had three does of the human papillomavirus (HPV) vaccine by their 13th birthday
HMO NameRateData Collection Method
UnitedHealthCare 7.83% Administrative
Aetna 10.52% Administrative
CIGNA 9.60% Administrative
Humana 4.45% Administrative
Regence 9.63% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 8.40%
 

Comprehensive Diabetes Care
Percentage of members with diabetes (18 - 75 years of age) who had an eye exam.
HMO NameRateData Collection Method
UnitedHealthCare 45.17% Admin+Chart Review
Aetna 32.26% Administrative
CIGNA 27.57% Administrative
Humana 38.44% Admin+Chart Review
Regence 39.46% Administrative
NATIONAL AVERAGE: 48.80% STATE AVERAGE: 36.57%
 
Comprehensive Diabetes Care
Percentage of members with diabetes (18 - 75 years of age) who had their Hemoglobin A1c tested.
HMO NameRateData Collection Method
UnitedHealthCare 88.16% Admin+Chart Review
Aetna 82.50% Administrative
CIGNA 87.14% Administrative
Humana 88.08% Admin+Chart Review
Regence 75.89% Administrative
NATIONAL AVERAGE: 87.17% STATE AVERAGE: 84.35%
 
Comprehensive Diabetes Care
Percentage of members with diabetes (18 - 75 years of age) who had their LDL-C level under control.
HMO NameRateData Collection Method
UnitedHealthCare 43.35% Admin+Chart Review
Aetna 0.00% Not Reportable
CIGNA 0.00% Not Reportable
Humana 36.50% Admin+Chart Review
Regence 0.00% Not Reportable
NATIONAL AVERAGE: 49.66% STATE AVERAGE: 39.92%
 
Comprehensive Diabetes Care
Percentage of members with diabetes (18 - 75 years of age) who had their LDL-C screened.
HMO NameRateData Collection Method
UnitedHealthCare 74.32% Admin+Chart Review
Aetna 69.86% Administrative
CIGNA 72.48% Administrative
Humana 76.89% Admin+Chart Review
Regence 64.95% Administrative
NATIONAL AVERAGE: 83.66% STATE AVERAGE: 71.70%
 
Comprehensive Diabetes Care
Percentage of members with diabetes (18 - 75 years of age) who had a blood pressure less than 140/90 Hg
HMO NameRateData Collection Method
UnitedHealthCare 63.39% Admin+Chart Review
Aetna 0.00% Not Reportable
CIGNA 0.00% Not Reportable
Humana 63.02% Admin+Chart Review
Regence 0.00% Not Reportable
NATIONAL AVERAGE: 58.33% STATE AVERAGE: 63.20%
 
Comprehensive Diabetes Care
Percentage of members with diabetes (18 - 75 years of age) who had a test for diabetic nephropathy.
HMO NameRateData Collection Method
UnitedHealthCare 78.69% Admin+Chart Review
Aetna 67.50% Administrative
CIGNA 72.92% Administrative
Humana 73.24% Admin+Chart Review
Regence 63.72% Administrative
NATIONAL AVERAGE: 78.59% STATE AVERAGE: 71.21%
 
Comprehensive Diabetes Care
Percentage of members with diabetes (18 - 75 years of age) who have poor HbA1c control (>9%). (Lower Rate is Better)
HMO NameRateData Collection Method
UnitedHealthCare 27.69% Admin+Chart Review
Aetna 0.00% Not Reportable
CIGNA 0.00% Not Reportable
Humana 38.44% Admin+Chart Review
Regence 0.00% Not Reportable
NATIONAL AVERAGE: 35.25% STATE AVERAGE: 33.06%
 

Appropriate Testing for Children with Pharyngitis
Percentage of children (2 -18 years of age) who were diagnosed with pharyngitis, dispensed an antibiotic and received a group A streptococcus (strep) test for the episode.
HMO NameRateData Collection Method
UnitedHealthCare 87.77% Administrative
Aetna 90.24% Administrative
CIGNA 86.76% Administrative
Humana 83.69% Administrative
Regence 84.92% Administrative
NATIONAL AVERAGE: 78.94% STATE AVERAGE: 86.67%
 
Appropriate Treatment for Children with Upper Respiratory Infection
Percentage of children (3 months - 18 years of age) who were given a diagnosis of upper respiratory infection and were not dispensed an antibiotic prescription.
HMO NameRateData Collection Method
UnitedHealthCare 87.83% Administrative
Aetna 90.71% Administrative
CIGNA 89.84% Administrative
Humana 85.19% Administrative
Regence 85.66% Administrative
NATIONAL AVERAGE: 82.33% STATE AVERAGE: 87.84%
 

Adolescent Well-Care Visit
Percentage of members (12 - 21 years of age) who had at least one comprehensive well-care visit.
HMO NameRateData Collection Method
UnitedHealthCare 29.56% Administrative
Aetna 32.27% Administrative
CIGNA 0.00% Not Reportable
Humana 30.66% Administrative
Regence 29.06% Administrative
NATIONAL AVERAGE: 40.15% STATE AVERAGE: 30.38%
 
Well-child visits in the 3rd/4th/5th/& 6th yr of life
Percentage of children (3 - 6 years of age) who received one or more well-child visits.
HMO NameRateData Collection Method
UnitedHealthCare 56.47% Administrative
Aetna 60.93% Administrative
CIGNA 0.00% Not Reportable
Humana 55.52% Administrative
Regence 56.07% Administrative
NATIONAL AVERAGE: 69.86% STATE AVERAGE: 57.24%
 
Well-Child Visits In The First 15 Months of Life
Percentage of children (less than 15 months old) that received at least six or more well-child visits.
HMO NameRateData Collection Method
UnitedHealthCare 0.00% Administrative
Aetna 71.97% Administrative
CIGNA 0.00% Not Reportable
Humana 45.63% Administrative
Regence 69.11% Administrative
NATIONAL AVERAGE: 76.36% STATE AVERAGE: 62.23%
 

Childhood Immunization Status
Percentage of children that received four DTaP; three IPV; one MMR; two HiB; three hepatitis B; and one VZV vaccination on or before their second birthday.
HMO NameRateData Collection Method
UnitedHealthCare 76.47% Admin+Chart Review
Aetna 25.02% Administrative
CIGNA 13.63% Administrative
Humana 49.64% Admin+Chart Review
Regence 55.15% Administrative
NATIONAL AVERAGE: 68.13% STATE AVERAGE: 43.98%
 
Childhood Immunization Status
Percentage of children that received four DTaP; three IPV; one MMR; two HiB; three hepatitis B; one VZV; and four pneumococcal conjugate vaccinations on or before their second birthday.
HMO NameRateData Collection Method
UnitedHealthCare 73.88% Admin+Chart Review
Aetna 23.93% Administrative
CIGNA 0.00% Not Reportable
Humana 46.72% Admin+Chart Review
Regence 53.81% Administrative
NATIONAL AVERAGE: 65.81% STATE AVERAGE: 49.58%
 
Childhood Immunization Status
Percentage of children that received four DTaP vaccinations on or before their second birthday.
HMO NameRateData Collection Method
UnitedHealthCare 83.76% Admin+Chart Review
Aetna 57.78% Administrative
CIGNA 40.87% Administrative
Humana 57.66% Admin+Chart Review
Regence 70.57% Administrative
NATIONAL AVERAGE: 79.98% STATE AVERAGE: 62.12%
 
Childhood Immunization Status
Percentage of children that received at least three hepatitis B vaccinations on or before their second birthday.
HMO NameRateData Collection Method
UnitedHealthCare 89.88% Admin+Chart Review
Aetna 29.51% Administrative
CIGNA 15.52% Administrative
Humana 60.58% Admin+Chart Review
Regence 65.81% Administrative
NATIONAL AVERAGE: 77.32% STATE AVERAGE: 52.25%
 
Childhood Immunization Status
Percentage of children that received at least two HiB vaccinations on or before their second birthday.
HMO NameRateData Collection Method
UnitedHealthCare 94.12% Admin+Chart Review
Aetna 71.26% Administrative
CIGNA 51.42% Administrative
Humana 72.51% Admin+Chart Review
Regence 70.18% Administrative
NATIONAL AVERAGE: 88.29% STATE AVERAGE: 71.89%
 
Childhood Immunization Status
Percentage of children that received at least one MMR vaccination on or before their second birthday.
HMO NameRateData Collection Method
UnitedHealthCare 88.94% Admin+Chart Review
Aetna 86.13% Administrative
CIGNA 83.05% Administrative
Humana 78.83% Admin+Chart Review
Regence 87.18% Administrative
NATIONAL AVERAGE: 88.32% STATE AVERAGE: 84.82%
 
Childhood Immunization Status
Percentage of children that received at least four pneumococcal conjugate vaccinations on or before their second birthday.
HMO NameRateData Collection Method
UnitedHealthCare 84.71% Admin+Chart Review
Aetna 57.94% Administrative
CIGNA 0.00% Not Reportable
Humana 58.39% Admin+Chart Review
Regence 72.49% Administrative
NATIONAL AVERAGE: 78.94% STATE AVERAGE: 68.38%
 
Childhood Immunization Status
Percentage of children that received at least one VZV vaccination on or before their second birthday.
HMO NameRateData Collection Method
UnitedHealthCare 91.06% Admin+Chart Review
Aetna 84.43% Administrative
CIGNA 82.58% Administrative
Humana 77.13% Admin+Chart Review
Regence 85.31% Administrative
NATIONAL AVERAGE: 88.04% STATE AVERAGE: 84.10%
 
Childhood Immunization Status
Percentage of children that received at least three IPV vaccinations on or before their second birthday.
HMO NameRateData Collection Method
UnitedHealthCare 92.94% Admin+Chart Review
Aetna 66.85% Administrative
CIGNA 48.45% Administrative
Humana 69.59% Admin+Chart Review
Regence 78.51% Administrative
NATIONAL AVERAGE: 86.26% STATE AVERAGE: 71.26%
 

Colorectal Cancer Screening
Percentage of members (51 - 80 years of age) who had appropriate screening for colorectal cancer.
HMO NameRateData Collection Method
UnitedHealthCare 61.63% Admin+Chart Review
Aetna 54.89% Administrative
CIGNA 44.85% Administrative
Humana 44.53% Admin+Chart Review
Regence 50.44% Administrative
NATIONAL AVERAGE: 55.77% STATE AVERAGE: 51.26%
 
Use of Imaging Studies for Low Back Pain
Percentage of members with a primary diagnosis of low back pain who did not have an imaging study (X-ray, MRI, CT scan) within 28 days of the diagnosis.
HMO NameRateData Collection Method
UnitedHealthCare 78.49% Administrative
Aetna 79.21% Administrative
CIGNA 78.67% Administrative
Humana 75.87% Administrative
Regence 77.00% Administrative
NATIONAL AVERAGE: 74.20% STATE AVERAGE: 77.84%
 
Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis
Percentage of adults (18-64 years of age) with a diagnosis of acute bronchitis who were not dispensed an antibiotic prescription
HMO NameRateData Collection Method
UnitedHealthCare 24.91% Administrative
Aetna 25.59% Administrative
CIGNA 21.02% Administrative
Humana 23.74% Administrative
Regence 25.01% Administrative
NATIONAL AVERAGE: 21.37% STATE AVERAGE: 24.05%
 
Cholesterol Management for Patients With Cardiovascular Conditions
Percentage of members with cardiovascular conditions (18-75 years of age) whose LDL-C cholesterol level was under 100mg/dL.
HMO NameRateData Collection Method
UnitedHealthCare 55.01% Administrative
Aetna 13.91% Administrative
CIGNA 0.00% Not Reportable
Humana 50.00% Administrative
Regence 0.00% Not Reportable
NATIONAL AVERAGE: 49.66% STATE AVERAGE: 39.64%
 
Cholesterol Management for Patients With Cardiovascular Conditions
Percentage of members with cardiovascular conditions (18-75 years of age) who had a cholesterol screening test.
HMO NameRateData Collection Method
UnitedHealthCare 61.22% Administrative
Aetna 70.30% Administrative
CIGNA 73.47% Administrative
Humana 84.85% Administrative
Regence 61.22% Administrative
NATIONAL AVERAGE: 83.66% STATE AVERAGE: 70.21%
 

Follow-Up After Hospitalization for Mental Illness
The percentage of members (6 years of age and older) who were hospitalized for treatment of selected mental health disorders and who had an follow-up visit within 30 days
HMO NameRateData Collection Method
UnitedHealthCare 72.52% Administrative
Aetna 68.97% Administrative
CIGNA 62.14% Administrative
Humana 35.94% Administrative
Regence 67.44% Administrative
NATIONAL AVERAGE: 72.19% STATE AVERAGE: 61.40%
 
Follow-Up After Hospitalization for Mental Illness
The percentage of members (6 years of age and older) who were hospitalized for treatment of selected mental health disorders and who had an follow-up visit within 7 days
HMO NameRateData Collection Method
UnitedHealthCare 57.27% Administrative
Aetna 51.72% Administrative
CIGNA 42.14% Administrative
Humana 25.00% Administrative
Regence 42.52% Administrative
NATIONAL AVERAGE: 52.97% STATE AVERAGE: 43.73%
 

Use of Appropriate Medications for People With Asthma
Percentage of members (5 - 50 years of age) during the measurement year who were identified as having persistent asthma and who were appropriately prescribed medication.
HMO NameRateData Collection Method
UnitedHealthCare 91.37% Administrative
Aetna 95.64% Administrative
CIGNA 92.20% Administrative
Humana 85.19% Administrative
Regence 90.43% Administrative
NATIONAL AVERAGE: 90.69% STATE AVERAGE: 90.96%
 
Asthma Medication Ratio
Percentage of members 5-64 years of age who were identified as having persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater during the measurement year.
HMO NameRateData Collection Method
UnitedHealthCare 74.78% Administrative
Aetna 83.05% Administrative
CIGNA 77.31% Administrative
Humana 68.15% Administrative
Regence 74.67% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 75.59%
 

Breast Cancer Screening
Percentage of women (40 - 69 years of age) who had a mammogram to screen for breast cancer.
HMO NameRateData Collection Method
UnitedHealthCare 60.88% Administrative
Aetna 58.42% Administrative
CIGNA 59.15% Administrative
Humana 56.64% Administrative
Regence 60.75% Administrative
NATIONAL AVERAGE: 66.52% STATE AVERAGE: 59.16%
 
Cervical Cancer Screening
Percentage of women (21 - 64 years of age) who received one or more Pap tests to screen for cervical cancer.
HMO NameRateData Collection Method
UnitedHealthCare 70.10% Administrative
Aetna 70.59% Administrative
CIGNA 69.29% Administrative
Humana 66.51% Administrative
Regence 66.80% Administrative
NATIONAL AVERAGE: 73.61% STATE AVERAGE: 68.65%
 
Chlamydia Screening in Women
Percentage of women (16 -24 years of age) who were identified as sexually active and who had at least one test for chlamydia during the measurement year.
HMO NameRateData Collection Method
UnitedHealthCare 31.72% Administrative
Aetna 28.89% Administrative
CIGNA 28.78% Administrative
Humana 22.85% Administrative
Regence 26.20% Administrative
NATIONAL AVERAGE: 42.32% STATE AVERAGE: 27.68%
 
Prenatal and Postpartum care
Percentage of deliveries that had a postpartum visit on or between 21 and 56 days after delivery.
HMO NameRateData Collection Method
UnitedHealthCare 73.94% Admin+Chart Review
Aetna 45.86% Administrative
CIGNA 49.64% Administrative
Humana 66.16% Admin+Chart Review
Regence 47.20% Administrative
NATIONAL AVERAGE: 70.03% STATE AVERAGE: 56.56%
 
Prenatal and Postpartum care
Percentage of deliveries that received a prenatal care visit in the first trimester or within 42 days of enrollment in the organization.
HMO NameRateData Collection Method
UnitedHealthCare 84.98% Admin+Chart Review
Aetna 25.94% Administrative
CIGNA 53.40% Administrative
Humana 72.56% Admin+Chart Review
Regence 27.29% Administrative
NATIONAL AVERAGE: 80.85% STATE AVERAGE: 52.83%