Health Plan Quality of Care Report for Utah Commercial HMOs, Medicaid & CHIP Health Plans (HEDIS)
MyHealthCare in Utah MyHealthCare in Utah
 
Commercial HMO Measures: 2015

Adults' Access to Preventive/Ambulatory Health Services
The percentage of members 20-44 years and older who had an ambulatory or preventive care visit.
Health PlanRateData Collection Method
Altius 92.82% Administrative
SelectHealth 92.84% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 87.70%
 
Adults' Access to Preventive/Ambulatory Health Services
The percentage of members 45-64 years and older who had an ambulatory or preventive care visit.
Health PlanRateData Collection Method
Altius 96.51% Administrative
SelectHealth 95.44% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 92.61%
 
Adults' Access to Preventive/Ambulatory Health Services
The percentage of members age 65+ years and older who had an ambulatory or preventive care visit.
Health PlanRateData Collection Method
Altius 98.51% Administrative
SelectHealth 97.11% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 90.84%
 
Adults' Access to Preventive/Ambulatory Health Services
The percentage of members 20 years and older who had an ambulatory or preventive care visit.
Health PlanRateData Collection Method
Altius 94.94% Administrative
SelectHealth 94.01% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 90.34%
 
Call Answer Timeliness
The percentage of calls received by the organization's Member Services call centers (during operating hours) that were answered by a live voice within 30 seconds.
Health PlanRateData Collection Method
SelectHealth 79.93% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 81.49%
 
Children and Adolescents' Access to Primary Care Practitioners
The percentage of adolescents 12–19 years who had a visit with a PCP or the year prior to the measurement year.
Health PlanRateData Collection Method
Altius 85.38% Administrative
SelectHealth 83.80% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 83.12%
 
Children and Adolescents' Access to Primary Care Practitioners
The percentage of children 12–24 months who had a visit with a PCP.
Health PlanRateData Collection Method
Altius 97.86% Administrative
SelectHealth 98.05% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 96.40%
 
Children and Adolescents' Access to Primary Care Practitioners
The percentage of children 25 months–6 years who had a visit with a PCP during the measure year.
Health PlanRateData Collection Method
Altius 84.93% Administrative
SelectHealth 86.11% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 83.10%
 
Children and Adolescents' Access to Primary Care Practitioners
The percentage of children 7–11 years who had a visit with a PCP during the measure year or the year prior to the measurement year.
Health PlanRateData Collection Method
Altius 81.59% Administrative
SelectHealth 80.82% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 80.44%
 
Initiation and Engagement of AOD Dependence Treatment
The percentage of members age 13-17 who initiate treatment through an inpatient AOD admission, outpatient visit, intensive outpatient encounter or partial hospitalization within 14 days of the diagnosis.
Health PlanRateData Collection Method
Altius 22.92% Administrative
SelectHealth 20.11% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 17.79%
 
Initiation and Engagement of AOD Dependence Treatment
The percentage of members age 18+ who initiate treatment through an inpatient AOD admission, outpatient visit, intensive outpatient encounter or partial hospitalization within 14 days of the diagnosis.
Health PlanRateData Collection Method
Altius 9.18% Administrative
SelectHealth 9.73% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 11.29%
 
Initiation and Engagement of AOD Dependence Treatment
The percentage of members who initiate treatment through an inpatient AOD admission, outpatient visit, intensive outpatient encounter or partial hospitalization within 14 days of the diagnosis.
Health PlanRateData Collection Method
Altius 9.95% Administrative
SelectHealth 10.36% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 11.64%
 
Initiation and Engagement of AOD Dependence Treatment
The percentage of members age 13-17 who initiated treatment and who had two or more additional services with a diagnosis of AOD within 30 days of the initiation visit.
Health PlanRateData Collection Method
Altius 43.75% Administrative
SelectHealth 47.93% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 44.38%
 
Initiation and Engagement of AOD Dependence Treatment
The percentage of members age 18+ who initiated treatment and who had two or more additional services with a diagnosis of AOD within 30 days of the initiation visit.
Health PlanRateData Collection Method
Altius 29.53% Administrative
SelectHealth 28.19% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 32.55%
 
Initiation and Engagement of AOD Dependence Treatment
The percentage of members who initiated treatment and who had two or more additional services with a diagnosis of AOD within 30 days of the initiation visit.
Health PlanRateData Collection Method
Altius 30.33% Administrative
SelectHealth 29.39% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 33.19%
 

Immunizations for Adolescents
The percentage of adolescents 13 years of age who had one dose of meningococcal vaccine and one Tdap vaccine or one tetanus, diphtheria toxoids vaccine (Td) by their 13th birthday.
Health PlanRateData Collection Method
Altius 64.84% Administrative
SelectHealth 80.00% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 66.77%
 
Immunizations for Adolescents
The percentage of adolescents 13 years of age who had one dose of meningococcal vaccine by their 13th birthday.
Health PlanRateData Collection Method
Altius 65.31% Administrative
SelectHealth 80.00% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 67.66%
 
Immunizations for Adolescents
The percentage of adolescents 13 years of age who had one Tdap vaccine or one tetanus, diphtheria toxoids vaccine (Td) by their 13th birthday.
Health PlanRateData Collection Method
Altius 91.05% Administrative
SelectHealth 93.73% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 86.45%
 
Human Papillomavirus Vaccine for Female Adolescents
The percentage of female adolescents 13 years of age who had three doses of the HPV vaccine by their 13th birthday.
Health PlanRateData Collection Method
Altius 12.21% Administrative
SelectHealth 18.98% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 16.63%
 

Comprehensive Diabetes Care
The percentage of adults 18–75 years of age with diabetes (type 1 and type 2) who had BP control (<140/90 mm Hg).
Health PlanRateData Collection Method
Altius 73.05% Admin+Chart Review
SelectHealth 74.64% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 51.36%
 
Comprehensive Diabetes Care
The percentage of adults 18–75 years of age with diabetes (type 1 and type 2) who had an eye exam (retinal) performed.
Health PlanRateData Collection Method
Altius 59.68% Admin+Chart Review
SelectHealth 67.15% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 49.74%
 
Comprehensive Diabetes Care
The percentage of adults 18–75 years of age with diabetes (type 1 and type 2) who had HbA1c control (<7.0%) for a selected population.
Health PlanRateData Collection Method
SelectHealth 40.18% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 21.90%
 
Comprehensive Diabetes Care
The percentage of adults 18–75 years of age with diabetes (type 1 and type 2) who had HbA1c control (<8.0%).
Health PlanRateData Collection Method
Altius 64.94% Admin+Chart Review
SelectHealth 62.23% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 45.30%
 
Comprehensive Diabetes Care
The percentage of adults 18–75 years of age with diabetes (type 1 and type 2) who had HbA1c poor control (>9.0%).
Health PlanRateData Collection Method
Altius 25.39% Admin+Chart Review
SelectHealth 23.72% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 48.69%
 
Comprehensive Diabetes Care
The percentage of adults 18–75 years of age with diabetes (type 1 and type 2) who had Hemoglobin A1c (HbA1c) testing.
Health PlanRateData Collection Method
Altius 91.46% Admin+Chart Review
SelectHealth 91.79% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 88.17%
 
Comprehensive Diabetes Care
The percentage of adults 18–75 years of age with diabetes (type 1 and type 2) who had medical attention for nephropathy.
Health PlanRateData Collection Method
Altius 84.85% Admin+Chart Review
SelectHealth 87.96% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 80.10%
 

Appropriate Testing for Children with Pharyngitis
The percentage of children 2-18 years of age who were diagnosed with pharyngitis and dispensed an antibiotic, and received a group A streptococcus test for the episode.
Health PlanRateData Collection Method
Altius 84.65% Administrative
SelectHealth 87.51% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 81.67%
 

Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had no well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
Altius 1.25% Administrative
SelectHealth 1.12% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 1.63%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had one well-child visit with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
Altius 0.94% Administrative
SelectHealth 1.19% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 1.68%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had two well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
Altius 1.56% Administrative
SelectHealth 1.19% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 1.56%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had three well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
Altius 2.59% Administrative
SelectHealth 1.73% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 3.29%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had four well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
Altius 5.80% Administrative
SelectHealth 4.83% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 7.92%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had five well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
Altius 17.96% Administrative
SelectHealth 13.29% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 18.39%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had at least six well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
Altius 69.88% Administrative
SelectHealth 76.63% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 66.47%
 
Adolescent Well-Care Visits
The percentage of eolled adolescents and young adults 12–21 years of age who had at least one comprehensive well-care visit with a primary care practitioner or an OB/GYN practitioner.
Health PlanRateData Collection Method
Altius 30.34% Administrative
SelectHealth 35.88% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 35.71%
 
Appropriate Treatment for Children With Upper Respiratory Infection (URI)
The percentage of children 3 months-18 years of age who were given a diagnosis of URI and were not dispensed an antibiotic prescription.
Health PlanRateData Collection Method
Altius 87.91% Administrative
SelectHealth 90.27% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 89.75%
 
Follow-Up Care for Children Prescribed ADHD Medication
The percentage of children between 6 and 12 years of age who had a prescription for ADHD medication and remained on it for at least 210 days, and had at least two follow-up visits in the 9 months subsequent to the Initiation Phase.
Health PlanRateData Collection Method
Altius 35.70% Administrative
SelectHealth 40.21% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 37.12%
 
Follow-Up Care for Children Prescribed ADHD Medication
The percentage of children between 6 and 12 years of age who were diagnosed with ADHD and had one follow-up visit with a practitioner with prescribing authority, within 30 days of their first prescription of ADHD medication.
Health PlanRateData Collection Method
Altius 34.69% Administrative
SelectHealth 36.13% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 33.85%
 
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
The percentage of children 3–17 years of age who had an outpatient visit with a primary care practitioner or OB/GYN and who had evidence of BMI percentile documentation.
Health PlanRateData Collection Method
Altius 43.57% Admin+Chart Review
SelectHealth 78.48% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 40.57%
 
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
The percentage of children 3–17 years of age who had an outpatient visit with a primary care practitioner or OB/GYN and who had evidence of counseling for nutrition.
Health PlanRateData Collection Method
Altius 47.71% Admin+Chart Review
SelectHealth 57.21% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 35.86%
 
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
The percentage of children 3–17 years of age who had an outpatient visit with a primary care practitioner or OB/GYN and who had evidence of counseling for physical activity.
Health PlanRateData Collection Method
Altius 45.32% Admin+Chart Review
SelectHealth 58.91% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 31.77%
 
Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life
The percentage of children 3–6 years of age who received one or more well-child visits with a primary care practitioner.
Health PlanRateData Collection Method
Altius 58.84% Administrative
SelectHealth 67.69% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 60.08%
 

Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); one (HepA); two or three (RV); and two (flu) vaccines by their second birthday.
Health PlanRateData Collection Method
Altius 48.30% Admin+Chart Review
SelectHealth 54.63% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 34.24%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB); and one (VZV) vaccines by their second birthday.
Health PlanRateData Collection Method
Altius 78.20% Admin+Chart Review
SelectHealth 83.66% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 57.69%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB); one (VZV); and four (PCV) vaccines by their second birthday.
Health PlanRateData Collection Method
Altius 77.08% Admin+Chart Review
SelectHealth 80.97% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 58.22%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); and one (HepA) vaccines by their second birthday.
Health PlanRateData Collection Method
Altius 76.40% Admin+Chart Review
SelectHealth 80.48% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 56.95%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); and two or three (RV) vaccines by their second birthday.
Health PlanRateData Collection Method
Altius 70.34% Admin+Chart Review
SelectHealth 74.88% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 51.15%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); and two (flu) vaccines by their second birthday.
Health PlanRateData Collection Method
Altius 52.35% Admin+Chart Review
SelectHealth 58.05% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 37.63%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); one (HepA); and two or three (RV) vaccines by their second birthday.
Health PlanRateData Collection Method
Altius 69.89% Admin+Chart Review
SelectHealth 74.39% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 50.47%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); one (HepA); and two (flu) vaccines by their second birthday.
Health PlanRateData Collection Method
Altius 52.13% Admin+Chart Review
SelectHealth 57.56% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 37.26%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); two or three (RV); and two (flu) vaccines by their second birthday.
Health PlanRateData Collection Method
Altius 48.54% Admin+Chart Review
SelectHealth 55.12% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 34.56%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP) vaccines by their second birthday.
Health PlanRateData Collection Method
Altius 81.80% Admin+Chart Review
SelectHealth 87.80% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 70.73%
 
Childhood Immunization Status
The percentage of children 2 years of age who had one (HepA) vaccine by their second birthday.
Health PlanRateData Collection Method
Altius 89.44% Admin+Chart Review
SelectHealth 94.15% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 87.15%
 
Childhood Immunization Status
The percentage of children 2 years of age who had three (HepB) vaccines by their second birthday.
Health PlanRateData Collection Method
Altius 92.13% Admin+Chart Review
SelectHealth 94.39% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 67.31%
 
Childhood Immunization Status
The percentage of children 2 years of age who had three (HiB) vaccines by their second birthday.
Health PlanRateData Collection Method
Altius 91.46% Admin+Chart Review
SelectHealth 94.15% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 80.40%
 
Childhood Immunization Status
The percentage of children 2 years of age who had two (flu) vaccines by their second birthday.
Health PlanRateData Collection Method
Altius 58.20% Admin+Chart Review
SelectHealth 64.39% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 51.87%
 
Childhood Immunization Status
The percentage of children 2 years of age who had three (IPV) vaccines by their second birthday.
Health PlanRateData Collection Method
Altius 92.13% Admin+Chart Review
SelectHealth 93.90% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 78.71%
 
Childhood Immunization Status
The percentage of children 2 years of age who had one (MMR) vaccine by their second birthday.
Health PlanRateData Collection Method
Altius 91.24% Admin+Chart Review
SelectHealth 93.17% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 87.66%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (PCV) vaccines by their second birthday.
Health PlanRateData Collection Method
Altius 84.49% Admin+Chart Review
SelectHealth 88.78% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 71.84%
 
Childhood Immunization Status
The percentage of children 2 years of age who had two or three (RV) vaccines by their second birthday.
Health PlanRateData Collection Method
Altius 80.00% Admin+Chart Review
SelectHealth 83.41% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 65.84%
 
Childhood Immunization Status
The percentage of children 2 years of age who had one (VZV) vaccine by their second birthday.
Health PlanRateData Collection Method
Altius 90.79% Admin+Chart Review
SelectHealth 93.41% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 86.57%
 

Colorectal Cancer Screening
The percentage of adults 50–75 years of age who had appropriate screening for colorectal cancer with any of the following tests: annual fecal occult blood test; flexible sigmoidoscopy every five years; or colonoscopy every ten years.
Health PlanRateData Collection Method
Altius 73.03% Admin+Chart Review
SelectHealth 72.70% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 56.01%
 
Use of Imaging Studies for Low Back Pain
The percentage of adults 18-50 years of age with a primary diagnosis of low back pain who did not have an imaging study (plain X-ray, MRI or CT scan) within 28 days of the diagnosis.
Health PlanRateData Collection Method
Altius 80.20% Administrative
SelectHealth 77.31% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 79.02%
 
Controlling High Blood Pressure
The percentage of adults 18–85 years of age who had a diagnosis of hypertension and whose blood pressure was adequately controlled.
Health PlanRateData Collection Method
Altius 63.24% Admin+Chart Review
SelectHealth 71.64% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 54.30%
 
Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis
The percentage of adults 18-64 years of age with a diagnosis of acute bronchitis who were not dispensed an antibiotic prescription.
Health PlanRateData Collection Method
Altius 32.19% Administrative
SelectHealth 37.82% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 35.94%
 
Adult BMI Assessment
The percentage of adults 18–74 years of age who had an outpatient visit and whose BMI was documented in the past two years.
Health PlanRateData Collection Method
Altius 82.66% Admin+Chart Review
SelectHealth 89.94% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 51.26%
 
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis
The percentage of adults diagnosed with RA who were dispensed at least one ambulatory prescription for a DMARD.
Health PlanRateData Collection Method
Altius 79.73% Administrative
SelectHealth 91.14% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 79.02%
 
Use of Spirometry Testing in the Assessment and Diagnosis of COPD
The percentage of adults 40 years of age and older with a new diagnosis of COPD or newly active COPD, who received spirometry testing to confirm the diagnosis.
Health PlanRateData Collection Method
Altius 38.59% Administrative
SelectHealth 42.18% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 37.21%
 

Follow-Up After Hospitalization for Mental Illness
The percentage of discharges for members 6 years of age and older who were hospitalized for treatment of selected mental health disorders and had a visit with a mental health practitioner within 30 days of discharge.
Health PlanRateData Collection Method
Altius 68.34% Administrative
SelectHealth 71.92% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 64.94%
 
Follow-Up After Hospitalization for Mental Illness
The percentage of discharges for members 6 years of age and older who were hospitalized for treatment of selected mental health disorders and had a visit with a mental health practitioner within 7 days of discharge.
Health PlanRateData Collection Method
Altius 50.30% Administrative
SelectHealth 48.77% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 45.89%
 
Metabolic Monitoring for children on Antipsychotics
The percentage of children 12-17 years of age who had two or more antipsychotic prescriptions and had metabolic testing.
Health PlanRateData Collection Method
Altius 28.42% Administrative
SelectHealth 38.08% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 27.59%
 
Metabolic Monitoring for children on Antipsychotics
The percentage of children 6-11 years of age who had two or more antipsychotic prescriptions and had metabolic testing.
Health PlanRateData Collection Method
SelectHealth 36.44% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 23.32%
 
Metabolic Monitoring for children on Antipsychotics
The percentage of children 1-17 years of age who had two or more antipsychotic prescriptions and had metabolic testing.
Health PlanRateData Collection Method
Altius 27.05% Administrative
SelectHealth 37.29% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 26.31%
 
Use of First-Line Psychosocial Care for children on Antipsychotics
The percentage of children 12-17 years of age who had a new prescription for an antipsychotic medication and had documentation of psychological care as first-line treatment.
Health PlanRateData Collection Method
Altius 46.34% Administrative
SelectHealth 53.66% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 51.82%
 
Use of First-Line Psychosocial Care for children on Antipsychotics
The percentage of children 6-11 years of age who had a new prescription for an antipsychotic medication and had documentation of psychological care as first-line treatment.
Health PlanRateData Collection Method
SelectHealth 34.54% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 50.61%
 
Use of First-Line Psychosocial Care for children on Antipsychotics
The percentage of children 1-17 years of age who had a new prescription for an antipsychotic medication and had documentation of psychological care as first-line treatment.
Health PlanRateData Collection Method
Altius 42.37% Administrative
SelectHealth 48.73% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 47.10%
 
Use of Multiple Concurrent Antipsychotics in Children and Adolescents
The percentage of children 12-17 years of age who were on two or more concurrent antipsychotic medications.
Health PlanRateData Collection Method
Altius 0.00% Administrative
SelectHealth 3.57% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 6.34%
 
Use of Multiple Concurrent Antipsychotics in Children and Adolescents
The percentage of children 6-11 years of age who were on two or more concurrent antipsychotic medications.
Health PlanRateData Collection Method
SelectHealth 2.08% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 3.13%
 
Use of Multiple Concurrent Antipsychotics in Children and Adolescents
The percentage of children 1-17 years of age who were on two or more concurrent antipsychotic medications.
Health PlanRateData Collection Method
Altius 0.00% Administrative
SelectHealth 3.13% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 6.39%
 

Use of Appropriate Medications for People With Asthma
The percentage of members 12-18 years of age with persistent asthma and who were appropriately prescribed medication.
Health PlanRateData Collection Method
Altius 90.91% Administrative
SelectHealth 94.22% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 90.77%
 
Use of Appropriate Medications for People With Asthma
The percentage of members 19-50 years of age with persistent asthma and who were appropriately prescribed medication.
Health PlanRateData Collection Method
Altius 86.05% Administrative
SelectHealth 90.27% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 84.26%
 
Use of Appropriate Medications for People With Asthma
The percentage of members 5-11 years of age with persistent asthma and who were appropriately prescribed medication.
Health PlanRateData Collection Method
Altius 90.91% Administrative
SelectHealth 98.00% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 96.27%
 
Use of Appropriate Medications for People With Asthma
The percentage of members 51-64 years of age with persistent asthma and who were appropriately prescribed medication.
Health PlanRateData Collection Method
Altius 91.97% Administrative
SelectHealth 93.38% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 87.27%
 
Use of Appropriate Medications for People With Asthma
The percentage of members 5-64 years of age with persistent asthma and who were appropriately prescribed medication.
Health PlanRateData Collection Method
Altius 89.12% Administrative
SelectHealth 92.83% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 89.76%
 
Persistence of Beta-Blocker Treatment After a Heart Attack
The percentage of adults 18 years of age and older who were hospitalized and discharged alive with a diagnosis of acute myocardial infarction and who received persistent beta-blocker treatment for six months after discharge.
Health PlanRateData Collection Method
Altius 75.00% Administrative
SelectHealth 82.95% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 70.77%
 
Asthma Medication Ratio
The percentage of adults and adolescents 12-18 years of age with persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater.
Health PlanRateData Collection Method
Altius 77.55% Administrative
SelectHealth 81.61% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 71.47%
 
Asthma Medication Ratio
The percentage of adults and adolescents 19-50 years of age with persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater.
Health PlanRateData Collection Method
Altius 68.95% Administrative
SelectHealth 74.22% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 65.27%
 
Asthma Medication Ratio
The percentage of adults and adolescents 5-11 years of age with persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater.
Health PlanRateData Collection Method
Altius 80.21% Administrative
SelectHealth 92.73% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 84.18%
 
Asthma Medication Ratio
The percentage of adults and adolescents 51-64 years of age with persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater.
Health PlanRateData Collection Method
Altius 78.39% Administrative
SelectHealth 85.71% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 76.29%
 
Asthma Medication Ratio
The percentage of adults and adolescents 5–64 years of age with persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater.
Health PlanRateData Collection Method
Altius 74.38% Administrative
SelectHealth 81.11% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 73.69%
 
Antidepressant Medication Management
The percentage of adults 18 years of age and older with a diagnosis of major depression, who were newly treated with antidepressant medication and remained on an antidepressant medication for at least 84 days (12 weeks).
Health PlanRateData Collection Method
Altius 59.66% Administrative
SelectHealth 64.16% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 61.47%
 
Antidepressant Medication Management
The percentage of adults 18 years of age and older with a diagnosis of major depression, who were newly treated with antidepressant medication and remained on an antidepressant medication for at least 180 days (6 months).
Health PlanRateData Collection Method
Altius 42.74% Administrative
SelectHealth 48.58% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 45.38%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 12-18 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 50 percent of the treatment period.
Health PlanRateData Collection Method
Altius 56.18% Administrative
SelectHealth 57.18% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 55.05%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 12-18 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 75 percent of the treatment period.
Health PlanRateData Collection Method
Altius 33.71% Administrative
SelectHealth 31.65% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 29.50%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 19-50 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 50 percent of the treatment period.
Health PlanRateData Collection Method
Altius 65.86% Administrative
SelectHealth 60.94% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 63.75%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 19-50 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 75 percent of the treatment period.
Health PlanRateData Collection Method
Altius 38.97% Administrative
SelectHealth 36.42% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 37.76%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 5-11 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 50 percent of the treatment period.
Health PlanRateData Collection Method
Altius 66.67% Administrative
SelectHealth 60.97% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 59.37%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 5-11 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 75 percent of the treatment period.
Health PlanRateData Collection Method
Altius 38.89% Administrative
SelectHealth 32.65% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 33.45%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 51-64 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 50 percent of the treatment period.
Health PlanRateData Collection Method
Altius 71.09% Administrative
SelectHealth 71.54% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 74.92%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 51-64 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 75 percent of the treatment period.
Health PlanRateData Collection Method
Altius 54.13% Administrative
SelectHealth 49.23% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 55.28%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 5-64 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 50 percent of the treatment period.
Health PlanRateData Collection Method
Altius 66.38% Administrative
SelectHealth 63.16% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 62.50%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 5-64 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 75 percent of the treatment period.
Health PlanRateData Collection Method
Altius 43.09% Administrative
SelectHealth 38.46% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 37.35%
 
Annual Monitoring for Patients on Persistent Medications
The percentage of adults 18 and older who received at least 180 treatment days of ambulatory medication therapy for angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARB).
Health PlanRateData Collection Method
Altius 78.42% Administrative
SelectHealth 79.81% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 80.23%
 
Annual Monitoring for Patients on Persistent Medications
The percentage of adults 18 and older who received at least 180 treatment days of ambulatory medication therapy for digoxin.
Health PlanRateData Collection Method
Altius 44.62% Administrative
SelectHealth 44.09% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 39.01%
 
Annual Monitoring for Patients on Persistent Medications
The percentage of adults 18 and older who received at least 180 treatment days of ambulatory medication therapy for diuretics.
Health PlanRateData Collection Method
Altius 78.22% Administrative
SelectHealth 77.41% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 78.64%
 
Annual Monitoring for Patients on Persistent Medications
The percentage of adults 18 and older who received at least 180 treatment days of ambulatory medication therapy for a select therapeutic agent and at least one therapeutic monitoring event for the therapeutic agent.
Health PlanRateData Collection Method
Altius 78.13% Administrative
SelectHealth 78.70% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 79.40%
 
Pharmacotherapy Management of COPD Exacerbation
The percentage of COPD exacerbations for adults 40 years and older who had an inpatient or ED visit with a primary discharge diagnosis of COPD and were dispensed a bronchodilator within 30 days of the event.
Health PlanRateData Collection Method
Altius 81.25% Administrative
SelectHealth 88.89% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 66.57%
 
Pharmacotherapy Management of COPD Exacerbation
The percentage of COPD exacerbations for adults 40 years and older who had an inpatient or ED visit with a primary discharge diagnosis of COPD and were dispensed a systemic corticosteroid within 14 days of the event.
Health PlanRateData Collection Method
Altius 65.63% Administrative
SelectHealth 76.19% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 54.21%
 

Breast Cancer Screening
The percentage of women 50–74 years of age who had at least one mammogram to screen for breast cancer in the past two years.
Health PlanRateData Collection Method
Altius 66.40% Administrative
SelectHealth 69.77% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 61.42%
 
Cervical Cancer Screening
The percentage of women 21–64 years of age who were screened for cervical cancer.
Health PlanRateData Collection Method
Altius 66.95% Administrative
SelectHealth 71.80% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 62.13%
 
Chlamydia Screening in Women
The percentage of women 16–20 years of age who were identified as sexually active and who had at least one test for chlamydia.
Health PlanRateData Collection Method
Altius 26.75% Administrative
SelectHealth 26.60% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 27.45%
 
Chlamydia Screening in Women
The percentage of women 21–24 years of age who were identified as sexually active and who had at least one test for chlamydia.
Health PlanRateData Collection Method
Altius 31.20% Administrative
SelectHealth 34.77% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 35.84%
 
Chlamydia Screening in Women
The percentage of women 16–24 years of age who were identified as sexually active and who had at least one test for chlamydia.
Health PlanRateData Collection Method
Altius 29.36% Administrative
SelectHealth 31.50% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 30.81%
 
Prenatal and Postpartum care
The percentage of deliveries that had a postpartum visit on or between 21 and 56 days after delivery.
Health PlanRateData Collection Method
Altius 76.49% Admin+Chart Review
SelectHealth 85.20% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 64.77%
 
Prenatal and Postpartum care
The percentage of deliveries that received a prenatal care visit as a member of the organization in the first trimester or within 42 days of eollment in the organization.
Health PlanRateData Collection Method
Altius 85.27% Admin+Chart Review
SelectHealth 95.41% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 70.13%
 
Non-Recommended Cervical Cancer Screening in Adolescent Females
The percentage of adolescent females 16–20 years of age who were screened unnecessarily for cervical cancer. Note: A lower rate indicates better performance.
Health PlanRateData Collection Method
Altius 3.74% Administrative
SelectHealth 2.72% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 2.25%
 
 
Medicaid Measures: 2015

Adults' Access to Preventive/Ambulatory Health Services
The percentage of members 20-44 years and older who had an ambulatory or preventive care visit.
Health PlanRateData Collection Method
Healthy U 84.83% Administrative
Molina 82.99% Administrative
SelectHealth 84.59% Administrative
Health Choice 81.44% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 87.70%
 
Adults' Access to Preventive/Ambulatory Health Services
The percentage of members 45-64 years and older who had an ambulatory or preventive care visit.
Health PlanRateData Collection Method
Healthy U 90.11% Administrative
Molina 88.98% Administrative
SelectHealth 90.93% Administrative
Health Choice 88.36% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 92.61%
 
Adults' Access to Preventive/Ambulatory Health Services
The percentage of members age 65+ years and older who had an ambulatory or preventive care visit.
Health PlanRateData Collection Method
Healthy U 89.30% Administrative
Molina 85.45% Administrative
SelectHealth 90.03% Administrative
Health Choice 76.25% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 90.84%
 
Adults' Access to Preventive/Ambulatory Health Services
The percentage of members 20 years and older who had an ambulatory or preventive care visit.
Health PlanRateData Collection Method
Healthy U 87.56% Administrative
Molina 85.15% Administrative
SelectHealth 87.24% Administrative
Health Choice 82.65% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 90.34%
 
Annual Dental Visit
The percentage of Medicaid members 11-14 years of age with dental benefits, who had at least one dental visit.
Health PlanRateData Collection Method
Delta Dental 58.16% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 63.47%
 
Annual Dental Visit
The percentage of Medicaid members 15-18 years of age with dental benefits, who had at least one dental visit.
Health PlanRateData Collection Method
Delta Dental 49.58% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 54.74%
 
Annual Dental Visit
The percentage of Medicaid members 19-21 years of age with dental benefits, who had at least one dental visit.
Health PlanRateData Collection Method
Delta Dental 38.91% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 19.45%
 
Annual Dental Visit
The percentage of Medicaid members 2-3 years of age with dental benefits, who had at least one dental visit.
Health PlanRateData Collection Method
Delta Dental 44.80% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 44.79%
 
Annual Dental Visit
The percentage of Medicaid members 4-6 years of age with dental benefits, who had at least one dental visit.
Health PlanRateData Collection Method
Delta Dental 62.47% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 68.25%
 
Annual Dental Visit
The percentage of Medicaid members 7-10 years of age with dental benefits, who had at least one dental visit.
Health PlanRateData Collection Method
Delta Dental 64.58% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 71.31%
 
Annual Dental Visit
The percentage of Medicaid members 2-21 years of age with dental benefits, who had at least one dental visit.
Health PlanRateData Collection Method
Delta Dental 57.41% Administrative
Premiere Dental 64.83% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 66.51%
 
Call Answer Timeliness
The percentage of calls received by the organization's Member Services call centers (during operating hours) that were answered by a live voice within 30 seconds.
Health PlanRateData Collection Method
Molina 88.06% Administrative
SelectHealth 76.70% Administrative
Health Choice 88.50% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 81.49%
 
Children and Adolescents' Access to Primary Care Practitioners
The percentage of adolescents 12–19 years who had a visit with a PCP or the year prior to the measurement year.
Health PlanRateData Collection Method
Healthy U 87.45% Administrative
Molina 88.75% Administrative
SelectHealth 88.82% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 83.12%
 
Children and Adolescents' Access to Primary Care Practitioners
The percentage of children 12–24 months who had a visit with a PCP.
Health PlanRateData Collection Method
Healthy U 97.11% Administrative
Molina 97.91% Administrative
SelectHealth 97.21% Administrative
Health Choice 94.59% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 96.40%
 
Children and Adolescents' Access to Primary Care Practitioners
The percentage of children 25 months–6 years who had a visit with a PCP during the measure year.
Health PlanRateData Collection Method
Healthy U 85.94% Administrative
Molina 86.38% Administrative
SelectHealth 86.11% Administrative
Health Choice 79.49% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 83.10%
 
Children and Adolescents' Access to Primary Care Practitioners
The percentage of children 7–11 years who had a visit with a PCP during the measure year or the year prior to the measurement year.
Health PlanRateData Collection Method
Healthy U 88.05% Administrative
Molina 88.62% Administrative
SelectHealth 87.72% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 80.44%
 

Immunizations for Adolescents
The percentage of adolescents 13 years of age who had one dose of meningococcal vaccine and one Tdap vaccine or one tetanus, diphtheria toxoids vaccine (Td) by their 13th birthday.
Health PlanRateData Collection Method
Healthy U 77.86% Admin+Chart Review
Molina 68.36% Admin+Chart Review
SelectHealth 74.76% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 66.77%
 
Immunizations for Adolescents
The percentage of adolescents 13 years of age who had one dose of meningococcal vaccine by their 13th birthday.
Health PlanRateData Collection Method
Healthy U 78.59% Admin+Chart Review
Molina 68.84% Admin+Chart Review
SelectHealth 77.00% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 67.66%
 
Immunizations for Adolescents
The percentage of adolescents 13 years of age who had one Tdap vaccine or one tetanus, diphtheria toxoids vaccine (Td) by their 13th birthday.
Health PlanRateData Collection Method
Healthy U 88.08% Admin+Chart Review
Molina 85.99% Admin+Chart Review
SelectHealth 87.86% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 86.45%
 
Human Papillomavirus Vaccine for Female Adolescents
The percentage of female adolescents 13 years of age who had three doses of the HPV vaccine by their 13th birthday.
Health PlanRateData Collection Method
Healthy U 26.72% Admin+Chart Review
Molina 20.09% Admin+Chart Review
SelectHealth 21.90% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 16.63%
 

Comprehensive Diabetes Care
The percentage of adults 18–75 years of age with diabetes (type 1 and type 2) who had BP control (<140/90 mm Hg).
Health PlanRateData Collection Method
Molina 69.87% Admin+Chart Review
SelectHealth 70.37% Admin+Chart Review
Health Choice 50.00% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 51.36%
 
Comprehensive Diabetes Care
The percentage of adults 18–75 years of age with diabetes (type 1 and type 2) who had an eye exam (retinal) performed.
Health PlanRateData Collection Method
Healthy U 44.23% Admin+Chart Review
Molina 66.06% Admin+Chart Review
SelectHealth 61.23% Admin+Chart Review
Health Choice 60.87% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 49.74%
 
Comprehensive Diabetes Care
The percentage of adults 18–75 years of age with diabetes (type 1 and type 2) who had HbA1c control (<8.0%).
Health PlanRateData Collection Method
Healthy U 45.60% Admin+Chart Review
Molina 54.91% Admin+Chart Review
SelectHealth 59.51% Admin+Chart Review
Health Choice 26.09% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 45.30%
 
Comprehensive Diabetes Care
The percentage of adults 18–75 years of age with diabetes (type 1 and type 2) who had HbA1c poor control (>9.0%).
Health PlanRateData Collection Method
Healthy U 46.58% Admin+Chart Review
Molina 32.36% Admin+Chart Review
SelectHealth 30.37% Admin+Chart Review
Health Choice 65.22% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 48.69%
 
Comprehensive Diabetes Care
The percentage of adults 18–75 years of age with diabetes (type 1 and type 2) who had Hemoglobin A1c (HbA1c) testing.
Health PlanRateData Collection Method
Healthy U 82.39% Admin+Chart Review
Molina 87.94% Admin+Chart Review
SelectHealth 89.63% Admin+Chart Review
Health Choice 86.96% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 88.17%
 
Comprehensive Diabetes Care
The percentage of adults 18–75 years of age with diabetes (type 1 and type 2) who had medical attention for nephropathy.
Health PlanRateData Collection Method
Healthy U 64.19% Admin+Chart Review
Molina 83.26% Admin+Chart Review
SelectHealth 91.60% Admin+Chart Review
Health Choice 82.61% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 80.10%
 

Appropriate Testing for Children with Pharyngitis
The percentage of children 2-18 years of age who were diagnosed with pharyngitis and dispensed an antibiotic, and received a group A streptococcus test for the episode.
Health PlanRateData Collection Method
Healthy U 66.91% Administrative
Molina 71.06% Administrative
SelectHealth 86.51% Administrative
Health Choice 78.72% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 81.67%
 
Lead Screening in Children
The percentage of children 2 years of age who had one or more blood tests for lead poisoning by their second birthday.
Health PlanRateData Collection Method
Healthy U 34.20% Administrative
Molina 21.85% Admin+Chart Review
SelectHealth 21.17% Admin+Chart Review
Health Choice 23.73% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 23.14%
 

Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had no well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
Healthy U 1.46% Admin+Chart Review
Molina 1.55% Admin+Chart Review
SelectHealth 0.91% Admin+Chart Review
Health Choice 2.44% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 1.63%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had one well-child visit with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
Healthy U 1.46% Admin+Chart Review
Molina 3.11% Admin+Chart Review
SelectHealth 2.13% Admin+Chart Review
Health Choice 3.66% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 1.68%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had two well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
Healthy U 2.92% Admin+Chart Review
Molina 2.00% Admin+Chart Review
SelectHealth 2.74% Admin+Chart Review
Health Choice 0.00% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 1.56%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had three well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
Healthy U 4.87% Admin+Chart Review
Molina 5.77% Admin+Chart Review
SelectHealth 5.48% Admin+Chart Review
Health Choice 2.44% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 3.29%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had four well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
Healthy U 11.68% Admin+Chart Review
Molina 7.33% Admin+Chart Review
SelectHealth 8.84% Admin+Chart Review
Health Choice 10.97% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 7.92%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had five well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
Healthy U 21.90% Admin+Chart Review
Molina 21.11% Admin+Chart Review
SelectHealth 20.73% Admin+Chart Review
Health Choice 30.49% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 18.39%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had at least six well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
Healthy U 55.72% Admin+Chart Review
Molina 59.11% Admin+Chart Review
SelectHealth 59.15% Admin+Chart Review
Health Choice 50.00% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 66.47%
 
Adolescent Well-Care Visits
The percentage of enrolled adolescents and young adults 12–21 years of age who had at least one comprehensive well-care visit with a primary care practitioner or an OB/GYN practitioner.
Health PlanRateData Collection Method
Healthy U 38.78% Administrative
Molina 43.93% Admin+Chart Review
SelectHealth 44.04% Admin+Chart Review
Health Choice 36.90% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 35.71%
 
Appropriate Treatment for Children With Upper Respiratory Infection (URI)
The percentage of children 3 months-18 years of age who were given a diagnosis of URI and were not dispensed an antibiotic prescription.
Health PlanRateData Collection Method
Healthy U 94.75% Administrative
Molina 92.43% Administrative
SelectHealth 93.28% Administrative
Health Choice 96.58% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 89.75%
 
Follow-Up Care for Children Prescribed ADHD Medication
The percentage of children between 6 and 12 years of age who had a prescription for ADHD medication and remained on it for at least 210 days, and had at least two follow-up visits in the 9 months subsequent to the Initiation Phase.
Health PlanRateData Collection Method
Healthy U 32.08% Administrative
Molina 30.65% Administrative
SelectHealth 23.33% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 37.12%
 
Follow-Up Care for Children Prescribed ADHD Medication
The percentage of children between 6 and 12 years of age who were diagnosed with ADHD and had one follow-up visit with a practitioner with prescribing authority, within 30 days of their first prescription of ADHD medication.
Health PlanRateData Collection Method
Healthy U 32.42% Administrative
Molina 30.08% Administrative
SelectHealth 39.82% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 33.85%
 
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
The percentage of children 3–17 years of age who had an outpatient visit with a primary care practitioner or OB/GYN and who had evidence of BMI percentile documentation.
Health PlanRateData Collection Method
Healthy U 2.63% Administrative
Molina 71.74% Admin+Chart Review
SelectHealth 85.61% Admin+Chart Review
Health Choice 28.22% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 40.57%
 
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
The percentage of children 3–17 years of age who had an outpatient visit with a primary care practitioner or OB/GYN and who had evidence of counseling for nutrition.
Health PlanRateData Collection Method
Healthy U 1.04% Administrative
Molina 54.30% Admin+Chart Review
SelectHealth 62.68% Admin+Chart Review
Health Choice 45.26% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 35.86%
 
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
The percentage of children 3–17 years of age who had an outpatient visit with a primary care practitioner or OB/GYN and who had evidence of counseling for physical activity.
Health PlanRateData Collection Method
Healthy U 0.13% Administrative
Molina 46.14% Admin+Chart Review
SelectHealth 56.10% Admin+Chart Review
Health Choice 34.31% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 31.77%
 
Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life
The percentage of children 3–6 years of age who received one or more well-child visits with a primary care practitioner.
Health PlanRateData Collection Method
Healthy U 59.12% Admin+Chart Review
Molina 59.08% Admin+Chart Review
SelectHealth 65.89% Admin+Chart Review
Health Choice 60.56% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 60.08%
 

Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); one (HepA); two or three (RV); and two (flu) vaccines by their second birthday.
Health PlanRateData Collection Method
Healthy U 32.85% Admin+Chart Review
Molina 40.83% Admin+Chart Review
SelectHealth 42.82% Admin+Chart Review
Health Choice 1.69% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 34.24%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB); and one (VZV) vaccines by their second birthday.
Health PlanRateData Collection Method
Healthy U 79.32% Admin+Chart Review
Molina 79.25% Admin+Chart Review
SelectHealth 78.10% Admin+Chart Review
Health Choice 5.08% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 57.69%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB); one (VZV); and four (PCV) vaccines by their second birthday.
Health PlanRateData Collection Method
Healthy U 75.18% Admin+Chart Review
Molina 75.94% Admin+Chart Review
SelectHealth 75.42% Admin+Chart Review
Health Choice 5.08% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 58.22%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); and one (HepA) vaccines by their second birthday.
Health PlanRateData Collection Method
Healthy U 72.98% Admin+Chart Review
Molina 74.61% Admin+Chart Review
SelectHealth 74.70% Admin+Chart Review
Health Choice 5.08% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 56.95%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); and two or three (RV) vaccines by their second birthday.
Health PlanRateData Collection Method
Healthy U 52.07% Admin+Chart Review
Molina 66.89% Admin+Chart Review
SelectHealth 64.95% Admin+Chart Review
Health Choice 5.08% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 51.15%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); and two (flu) vaccines by their second birthday.
Health PlanRateData Collection Method
Healthy U 44.04% Admin+Chart Review
Molina 44.59% Admin+Chart Review
SelectHealth 47.69% Admin+Chart Review
Health Choice 1.69% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 37.63%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); one (HepA); and two or three (RV) vaccines by their second birthday.
Health PlanRateData Collection Method
Healthy U 51.58% Admin+Chart Review
Molina 66.00% Admin+Chart Review
SelectHealth 64.48% Admin+Chart Review
Health Choice 5.08% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 50.47%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); one (HepA); and two (flu) vaccines by their second birthday.
Health PlanRateData Collection Method
Healthy U 43.55% Admin+Chart Review
Molina 44.15% Admin+Chart Review
SelectHealth 47.69% Admin+Chart Review
Health Choice 1.69% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 37.26%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); two or three (RV); and two (flu) vaccines by their second birthday.
Health PlanRateData Collection Method
Healthy U 32.85% Admin+Chart Review
Molina 41.28% Admin+Chart Review
SelectHealth 42.82% Admin+Chart Review
Health Choice 1.69% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 34.56%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP) vaccines by their second birthday.
Health PlanRateData Collection Method
Healthy U 83.45% Admin+Chart Review
Molina 81.89% Admin+Chart Review
SelectHealth 81.27% Admin+Chart Review
Health Choice 13.56% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 70.73%
 
Childhood Immunization Status
The percentage of children 2 years of age who had one (HepA) vaccine by their second birthday.
Health PlanRateData Collection Method
Healthy U 90.27% Admin+Chart Review
Molina 86.75% Admin+Chart Review
SelectHealth 88.81% Admin+Chart Review
Health Choice 79.66% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 87.15%
 
Childhood Immunization Status
The percentage of children 2 years of age who had three (HepB) vaccines by their second birthday.
Health PlanRateData Collection Method
Healthy U 89.29% Admin+Chart Review
Molina 91.39% Admin+Chart Review
SelectHealth 92.46% Admin+Chart Review
Health Choice 6.78% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 67.31%
 
Childhood Immunization Status
The percentage of children 2 years of age who had three (HiB) vaccines by their second birthday.
Health PlanRateData Collection Method
Healthy U 93.19% Admin+Chart Review
Molina 91.17% Admin+Chart Review
SelectHealth 90.75% Admin+Chart Review
Health Choice 25.42% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 80.40%
 
Childhood Immunization Status
The percentage of children 2 years of age who had two (flu) vaccines by their second birthday.
Health PlanRateData Collection Method
Healthy U 49.88% Admin+Chart Review
Molina 49.23% Admin+Chart Review
SelectHealth 53.28% Admin+Chart Review
Health Choice 28.81% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 51.87%
 
Childhood Immunization Status
The percentage of children 2 years of age who had three (IPV) vaccines by their second birthday.
Health PlanRateData Collection Method
Healthy U 91.73% Admin+Chart Review
Molina 91.17% Admin+Chart Review
SelectHealth 89.78% Admin+Chart Review
Health Choice 20.34% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 78.71%
 
Childhood Immunization Status
The percentage of children 2 years of age who had one (MMR) vaccine by their second birthday.
Health PlanRateData Collection Method
Healthy U 93.19% Admin+Chart Review
Molina 88.96% Admin+Chart Review
SelectHealth 90.27% Admin+Chart Review
Health Choice 81.36% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 87.66%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (PCV) vaccines by their second birthday.
Health PlanRateData Collection Method
Healthy U 83.21% Admin+Chart Review
Molina 81.67% Admin+Chart Review
SelectHealth 80.78% Admin+Chart Review
Health Choice 13.56% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 71.84%
 
Childhood Immunization Status
The percentage of children 2 years of age who had two or three (RV) vaccines by their second birthday.
Health PlanRateData Collection Method
Healthy U 58.39% Admin+Chart Review
Molina 73.29% Admin+Chart Review
SelectHealth 72.02% Admin+Chart Review
Health Choice 11.86% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 65.84%
 
Childhood Immunization Status
The percentage of children 2 years of age who had one (VZV) vaccine by their second birthday.
Health PlanRateData Collection Method
Healthy U 91.97% Admin+Chart Review
Molina 89.40% Admin+Chart Review
SelectHealth 90.27% Admin+Chart Review
Health Choice 77.97% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 86.57%
 

Use of Imaging Studies for Low Back Pain
The percentage of adults 18-50 years of age with a primary diagnosis of low back pain who did not have an imaging study (plain X-ray, MRI or CT scan) within 28 days of the diagnosis.
Health PlanRateData Collection Method
Healthy U 71.85% Administrative
Molina 80.12% Administrative
SelectHealth 81.43% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 79.02%
 
Controlling High Blood Pressure
The percentage of adults 18–85 years of age who had a diagnosis of hypertension and whose blood pressure was adequately controlled.
Health PlanRateData Collection Method
Healthy U 65.93% Admin+Chart Review
Molina 68.47% Admin+Chart Review
SelectHealth 68.34% Admin+Chart Review
Health Choice 45.90% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 54.30%
 
Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis
The percentage of adults 18-64 years of age with a diagnosis of acute bronchitis who were not dispensed an antibiotic prescription.
Health PlanRateData Collection Method
Healthy U 45.24% Administrative
Molina 35.69% Administrative
SelectHealth 57.86% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 35.94%
 
Adult BMI Assessment
The percentage of adults 18–74 years of age who had an outpatient visit and whose BMI was documented in the past two years.
Health PlanRateData Collection Method
Healthy U 18.38% Administrative
Molina 91.23% Admin+Chart Review
SelectHealth 95.28% Admin+Chart Review
Health Choice 81.82% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 51.26%
 
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis
The percentage of adults diagnosed with RA who were dispensed at least one ambulatory prescription for a DMARD.
Health PlanRateData Collection Method
Healthy U 48.05% Administrative
Molina 70.59% Administrative
SelectHealth 55.81% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 79.02%
 
Use of Spirometry Testing in the Assessment and Diagnosis of COPD
The percentage of adults 40 years of age and older with a new diagnosis of COPD or newly active COPD, who received spirometry testing to confirm the diagnosis.
Health PlanRateData Collection Method
Healthy U 21.54% Administrative
Molina 34.25% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 37.21%
 

Use of Appropriate Medications for People With Asthma
The percentage of members 12-18 years of age with persistent asthma and who were appropriately prescribed medication.
Health PlanRateData Collection Method
Healthy U 83.33% Administrative
Molina 82.78% Administrative
SelectHealth 90.39% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 90.77%
 
Use of Appropriate Medications for People With Asthma
The percentage of members 19-50 years of age with persistent asthma and who were appropriately prescribed medication.
Health PlanRateData Collection Method
Healthy U 68.60% Administrative
Molina 76.34% Administrative
SelectHealth 84.00% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 84.26%
 
Use of Appropriate Medications for People With Asthma
The percentage of members 5-11 years of age with persistent asthma and who were appropriately prescribed medication.
Health PlanRateData Collection Method
Healthy U 89.58% Administrative
Molina 91.18% Administrative
SelectHealth 97.96% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 96.27%
 
Use of Appropriate Medications for People With Asthma
The percentage of members 51-64 years of age with persistent asthma and who were appropriately prescribed medication.
Health PlanRateData Collection Method
Healthy U 76.67% Administrative
Molina 76.31% Administrative
SelectHealth 64.14% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 87.27%
 
Use of Appropriate Medications for People With Asthma
The percentage of members 5-64 years of age with persistent asthma and who were appropriately prescribed medication.
Health PlanRateData Collection Method
Healthy U 80.34% Administrative
Molina 83.73% Administrative
SelectHealth 89.66% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 89.76%
 
Asthma Medication Ratio
The percentage of adults and adolescents 12-18 years of age with persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater.
Health PlanRateData Collection Method
Healthy U 51.52% Administrative
Molina 60.26% Administrative
SelectHealth 63.60% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 71.47%
 
Asthma Medication Ratio
The percentage of adults and adolescents 19-50 years of age with persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater.
Health PlanRateData Collection Method
Healthy U 48.00% Administrative
Molina 51.34% Administrative
SelectHealth 53.02% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 65.27%
 
Asthma Medication Ratio
The percentage of adults and adolescents 5-11 years of age with persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater.
Health PlanRateData Collection Method
Healthy U 58.02% Administrative
Molina 74.38% Administrative
SelectHealth 84.90% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 84.18%
 
Asthma Medication Ratio
The percentage of adults and adolescents 51-64 years of age with persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater.
Health PlanRateData Collection Method
Molina 52.63% Administrative
SelectHealth 47.17% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 76.29%
 
Asthma Medication Ratio
The percentage of adults and adolescents 5–64 years of age with persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater.
Health PlanRateData Collection Method
Healthy U 52.21% Administrative
Molina 62.59% Administrative
SelectHealth 67.70% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 73.69%
 
Antidepressant Medication Management
The percentage of adults 18 years of age and older with a diagnosis of major depression, who were newly treated with antidepressant medication and remained on an antidepressant medication for at least 84 days (12 weeks).
Health PlanRateData Collection Method
Healthy U 39.83% Administrative
Molina 53.16% Administrative
SelectHealth 65.79% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 61.47%
 
Antidepressant Medication Management
The percentage of adults 18 years of age and older with a diagnosis of major depression, who were newly treated with antidepressant medication and remained on an antidepressant medication for at least 180 days (6 months).
Health PlanRateData Collection Method
Healthy U 24.93% Administrative
Molina 37.36% Administrative
SelectHealth 50.00% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 45.38%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 12-18 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 50 percent of the treatment period.
Health PlanRateData Collection Method
Healthy U 55.38% Administrative
Molina 50.40% Administrative
SelectHealth 45.67% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 55.05%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 12-18 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 75 percent of the treatment period.
Health PlanRateData Collection Method
Healthy U 26.15% Administrative
Molina 28.00% Administrative
SelectHealth 21.63% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 29.50%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 19-50 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 50 percent of the treatment period.
Health PlanRateData Collection Method
Healthy U 47.46% Administrative
Molina 61.95% Administrative
SelectHealth 57.94% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 63.75%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 19-50 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 75 percent of the treatment period.
Health PlanRateData Collection Method
Healthy U 22.03% Administrative
Molina 39.82% Administrative
SelectHealth 38.10% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 37.76%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 5-11 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 50 percent of the treatment period.
Health PlanRateData Collection Method
Healthy U 39.53% Administrative
Molina 58.06% Administrative
SelectHealth 50.83% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 59.37%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 5-11 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 75 percent of the treatment period.
Health PlanRateData Collection Method
Healthy U 17.44% Administrative
Molina 27.42% Administrative
SelectHealth 27.92% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 33.45%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 51-64 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 50 percent of the treatment period.
Health PlanRateData Collection Method
SelectHealth 58.81% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 74.92%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 51-64 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 75 percent of the treatment period.
Health PlanRateData Collection Method
SelectHealth 50.00% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 55.28%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 5-64 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 50 percent of the treatment period.
Health PlanRateData Collection Method
Healthy U 48.07% Administrative
Molina 57.40% Administrative
SelectHealth 50.99% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 62.50%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 5-64 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 75 percent of the treatment period.
Health PlanRateData Collection Method
Healthy U 22.32% Administrative
Molina 32.01% Administrative
SelectHealth 29.11% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 37.35%
 
Annual Monitoring for Patients on Persistent Medications
The percentage of adults 18 and older who received at least 180 treatment days of ambulatory medication therapy for angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARB).
Health PlanRateData Collection Method
Healthy U 87.42% Administrative
Molina 88.18% Administrative
SelectHealth 84.46% Administrative
Health Choice 80.00% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 80.23%
 
Annual Monitoring for Patients on Persistent Medications
The percentage of adults 18 and older who received at least 180 treatment days of ambulatory medication therapy for diuretics.
Health PlanRateData Collection Method
Healthy U 85.22% Administrative
Molina 88.93% Administrative
SelectHealth 85.67% Administrative
Health Choice 75.00% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 78.64%
 
Annual Monitoring for Patients on Persistent Medications
The percentage of adults 18 and older who received at least 180 treatment days of ambulatory medication therapy for a select therapeutic agent and at least one therapeutic monitoring event for the therapeutic agent.
Health PlanRateData Collection Method
Healthy U 86.24% Administrative
Molina 88.12% Administrative
SelectHealth 84.43% Administrative
Health Choice 78.16% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 79.40%
 
Pharmacotherapy Management of COPD Exacerbation
The percentage of COPD exacerbations for adults 40 years and older who had an inpatient or ED visit with a primary discharge diagnosis of COPD and were dispensed a bronchodilator within 30 days of the event.
Health PlanRateData Collection Method
Healthy U 47.37% Administrative
Molina 67.56% Administrative
SelectHealth 32.43% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 66.57%
 
Pharmacotherapy Management of COPD Exacerbation
The percentage of COPD exacerbations for adults 40 years and older who had an inpatient or ED visit with a primary discharge diagnosis of COPD and were dispensed a systemic corticosteroid within 14 days of the event.
Health PlanRateData Collection Method
Healthy U 30.70% Administrative
Molina 54.05% Administrative
SelectHealth 25.00% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 54.21%
 

Breast Cancer Screening
The percentage of women 50–74 years of age who had at least one mammogram to screen for breast cancer in the past two years.
Health PlanRateData Collection Method
Healthy U 47.69% Administrative
Molina 45.76% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 61.42%
 
Cervical Cancer Screening
The percentage of women 21–64 years of age who were screened for cervical cancer.
Health PlanRateData Collection Method
Healthy U 50.24% Admin+Chart Review
Molina 62.09% Admin+Chart Review
SelectHealth 59.80% Admin+Chart Review
Health Choice 42.74% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 62.13%
 
Chlamydia Screening in Women
The percentage of women 16–20 years of age who were identified as sexually active and who had at least one test for chlamydia.
Health PlanRateData Collection Method
Healthy U 35.65% Administrative
Molina 31.06% Administrative
SelectHealth 37.14% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 27.45%
 
Chlamydia Screening in Women
The percentage of women 21–24 years of age who were identified as sexually active and who had at least one test for chlamydia.
Health PlanRateData Collection Method
Healthy U 44.44% Administrative
Molina 47.99% Administrative
SelectHealth 45.54% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 35.84%
 
Chlamydia Screening in Women
The percentage of women 16–24 years of age who were identified as sexually active and who had at least one test for chlamydia.
Health PlanRateData Collection Method
Healthy U 39.37% Administrative
Molina 37.07% Administrative
SelectHealth 40.42% Administrative
Health Choice 32.43% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 30.81%
 
Prenatal and Postpartum care
The percentage of deliveries that had a postpartum visit on or between 21 and 56 days after delivery.
Health PlanRateData Collection Method
Healthy U 65.59% Admin+Chart Review
Molina 67.49% Admin+Chart Review
SelectHealth 76.72% Admin+Chart Review
Health Choice 64.89% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 64.77%
 
Prenatal and Postpartum care
The percentage of deliveries that received a prenatal care visit as a member of the organization in the first trimester or within 42 days of enrollment in the organization.
Health PlanRateData Collection Method
Healthy U 75.81% Admin+Chart Review
Molina 88.12% Admin+Chart Review
SelectHealth 93.39% Admin+Chart Review
Health Choice 62.67% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 70.13%
 
Frequency of Ongoing Prenatal Care
The percentage of Medicaid deliveries during the measurement period where there were less 21 percent of the expected number of prenatal care visits, adjusted for gestational age and month of enrollment.
Health PlanRateData Collection Method
Healthy U 12.59% Admin+Chart Review
Molina 12.33% Admin+Chart Review
SelectHealth 3.74% Admin+Chart Review
Health Choice 32.44% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 15.27%
 
Frequency of Ongoing Prenatal Care
The percentage of Medicaid deliveries during the measurement period where there were 21 percent–40 percent of the expected number of prenatal care visits, adjusted for gestational age and month of enrollment.
Health PlanRateData Collection Method
Healthy U 7.90% Admin+Chart Review
Molina 4.71% Admin+Chart Review
SelectHealth 1.72% Admin+Chart Review
Health Choice 9.77% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 6.02%
 
Frequency of Ongoing Prenatal Care
The percentage of Medicaid deliveries during the measurement period where there were 41 percent–60 percent of the expected number of prenatal care visits, adjusted for gestational age and month of enrollment.
Health PlanRateData Collection Method
Healthy U 8.40% Admin+Chart Review
Molina 8.52% Admin+Chart Review
SelectHealth 7.47% Admin+Chart Review
Health Choice 3.56% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 6.98%
 
Frequency of Ongoing Prenatal Care
The percentage of Medicaid deliveries during the measurement period where there were 61 percent–80 percent of the expected number of prenatal care visits, adjusted for gestational age and month of enrollment.
Health PlanRateData Collection Method
Healthy U 19.00% Admin+Chart Review
Molina 17.48% Admin+Chart Review
SelectHealth 24.14% Admin+Chart Review
Health Choice 8.00% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 17.16%
 
Frequency of Ongoing Prenatal Care
The percentage of Medicaid deliveries during the measurement period where there were greater than 81 percent of the expected number of prenatal care visits, adjusted for gestational age and month of enrollment.
Health PlanRateData Collection Method
Healthy U 52.10% Admin+Chart Review
Molina 56.95% Admin+Chart Review
SelectHealth 62.93% Admin+Chart Review
Health Choice 46.22% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 54.55%
 
Non-Recommended Cervical Cancer Screening in Adolescent Females
The percentage of adolescent females 16–20 years of age who were screened unnecessarily for cervical cancer. Note: A lower rate indicates better performance.
Health PlanRateData Collection Method
Healthy U 1.14% Administrative
Molina 2.09% Administrative
SelectHealth 2.54% Administrative
Health Choice 2.17% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 2.25%
 
 
CHIP Measures: 2015

Annual Dental Visit
The percentage of Medicaid members 11-14 years of age with dental benefits, who had at least one dental visit.
Health PlanRateData Collection Method
DentaQuest 68.78% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 63.47%
 
Annual Dental Visit
The percentage of Medicaid members 15-18 years of age with dental benefits, who had at least one dental visit.
Health PlanRateData Collection Method
DentaQuest 59.90% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 54.74%
 
Annual Dental Visit
The percentage of Medicaid members 19-21 years of age with dental benefits, who had at least one dental visit.
Health PlanRateData Collection Method
DentaQuest 0.00% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 19.45%
 
Annual Dental Visit
The percentage of Medicaid members 2-3 years of age with dental benefits, who had at least one dental visit.
Health PlanRateData Collection Method
DentaQuest 44.78% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 44.79%
 
Annual Dental Visit
The percentage of Medicaid members 4-6 years of age with dental benefits, who had at least one dental visit.
Health PlanRateData Collection Method
DentaQuest 74.03% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 68.25%
 
Annual Dental Visit
The percentage of Medicaid members 7-10 years of age with dental benefits, who had at least one dental visit.
Health PlanRateData Collection Method
DentaQuest 78.03% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 71.31%
 
Annual Dental Visit
The percentage of Medicaid members 2-21 years of age with dental benefits, who had at least one dental visit.
Health PlanRateData Collection Method
DentaQuest 68.28% Administrative
Premiere Dental 75.53% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 66.51%
 
Call Answer Timeliness
The percentage of calls received by the organization's Member Services call centers (during operating hours) that were answered by a live voice within 30 seconds.
Health PlanRateData Collection Method
Molina 88.06% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 81.49%
 
Children and Adolescents' Access to Primary Care Practitioners
The percentage of adolescents 12–19 years who had a visit with a PCP or the year prior to the measurement year.
Health PlanRateData Collection Method
Molina 86.58% Administrative
SelectHealth 89.05% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 83.12%
 
Children and Adolescents' Access to Primary Care Practitioners
The percentage of children 12–24 months who had a visit with a PCP.
Health PlanRateData Collection Method
Molina 100.00% Administrative
SelectHealth 99.63% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 96.40%
 
Children and Adolescents' Access to Primary Care Practitioners
The percentage of children 25 months–6 years who had a visit with a PCP during the measure year.
Health PlanRateData Collection Method
Molina 88.09% Administrative
SelectHealth 87.80% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 83.10%
 
Children and Adolescents' Access to Primary Care Practitioners
The percentage of children 7–11 years who had a visit with a PCP during the measure year or the year prior to the measurement year.
Health PlanRateData Collection Method
Molina 89.78% Administrative
SelectHealth 85.17% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 80.44%
 

Immunizations for Adolescents
The percentage of adolescents 13 years of age who had one dose of meningococcal vaccine and one Tdap vaccine or one tetanus, diphtheria toxoids vaccine (Td) by their 13th birthday.
Health PlanRateData Collection Method
Molina 75.20% Admin+Chart Review
SelectHealth 71.31% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 66.77%
 
Immunizations for Adolescents
The percentage of adolescents 13 years of age who had one dose of meningococcal vaccine by their 13th birthday.
Health PlanRateData Collection Method
Molina 75.59% Admin+Chart Review
SelectHealth 71.31% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 67.66%
 
Immunizations for Adolescents
The percentage of adolescents 13 years of age who had one Tdap vaccine or one tetanus, diphtheria toxoids vaccine (Td) by their 13th birthday.
Health PlanRateData Collection Method
Molina 93.60% Admin+Chart Review
SelectHealth 95.26% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 86.45%
 
Human Papillomavirus Vaccine for Female Adolescents
The percentage of female adolescents 13 years of age who had three doses of the HPV vaccine by their 13th birthday.
Health PlanRateData Collection Method
Molina 28.36% Admin+Chart Review
SelectHealth 26.34% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 16.63%
 

Appropriate Testing for Children with Pharyngitis
The percentage of children 2-18 years of age who were diagnosed with pharyngitis and dispensed an antibiotic, and received a group A streptococcus test for the episode.
Health PlanRateData Collection Method
Molina 68.02% Administrative
SelectHealth 83.55% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 81.67%
 
Lead Screening in Children
The percentage of children 2 years of age who had one or more blood tests for lead poisoning by their second birthday.
Health PlanRateData Collection Method
Molina 19.88% Admin+Chart Review
SelectHealth 18.04% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 23.14%
 

Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had no well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
Molina 0.94% Admin+Chart Review
SelectHealth 0.44% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 1.63%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had one well-child visit with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
Molina 0.00% Admin+Chart Review
SelectHealth 0.44% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 1.68%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had two well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
Molina 0.94% Admin+Chart Review
SelectHealth 0.44% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 1.56%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had three well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
Molina 2.83% Admin+Chart Review
SelectHealth 1.34% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 3.29%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had four well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
Molina 12.26% Admin+Chart Review
SelectHealth 7.59% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 7.92%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had five well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
Molina 12.26% Admin+Chart Review
SelectHealth 17.41% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 18.39%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had at least six well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
Molina 70.75% Admin+Chart Review
SelectHealth 72.31% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 66.47%
 
Adolescent Well-Care Visits
The percentage of enrolled adolescents and young adults 12–21 years of age who had at least one comprehensive well-care visit with a primary care practitioner or an OB/GYN practitioner.
Health PlanRateData Collection Method
Molina 44.81% Admin+Chart Review
SelectHealth 48.91% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 35.71%
 
Appropriate Treatment for Children With Upper Respiratory Infection (URI)
The percentage of children 3 months-18 years of age who were given a diagnosis of URI and were not dispensed an antibiotic prescription.
Health PlanRateData Collection Method
Molina 90.09% Administrative
SelectHealth 89.57% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 89.75%
 
Follow-Up Care for Children Prescribed ADHD Medication
The percentage of children between 6 and 12 years of age who had a prescription for ADHD medication and remained on it for at least 210 days, and had at least two follow-up visits in the 9 months subsequent to the Initiation Phase.
Health PlanRateData Collection Method
SelectHealth 47.22% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 37.12%
 
Follow-Up Care for Children Prescribed ADHD Medication
The percentage of children between 6 and 12 years of age who were diagnosed with ADHD and had one follow-up visit with a practitioner with prescribing authority, within 30 days of their first prescription of ADHD medication.
Health PlanRateData Collection Method
Molina 36.94% Administrative
SelectHealth 38.97% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 33.85%
 
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
The percentage of children 3–17 years of age who had an outpatient visit with a primary care practitioner or OB/GYN and who had evidence of BMI percentile documentation.
Health PlanRateData Collection Method
Molina 67.55% Admin+Chart Review
SelectHealth 79.12% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 40.57%
 
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
The percentage of children 3–17 years of age who had an outpatient visit with a primary care practitioner or OB/GYN and who had evidence of counseling for nutrition.
Health PlanRateData Collection Method
Molina 57.84% Admin+Chart Review
SelectHealth 54.79% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 35.86%
 
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
The percentage of children 3–17 years of age who had an outpatient visit with a primary care practitioner or OB/GYN and who had evidence of counseling for physical activity.
Health PlanRateData Collection Method
Molina 51.43% Admin+Chart Review
SelectHealth 54.30% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 31.77%
 
Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life
The percentage of children 3–6 years of age who received one or more well-child visits with a primary care practitioner.
Health PlanRateData Collection Method
Molina 63.70% Admin+Chart Review
SelectHealth 66.22% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 60.08%
 

Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); one (HepA); two or three (RV); and two (flu) vaccines by their second birthday.
Health PlanRateData Collection Method
Molina 48.54% Admin+Chart Review
SelectHealth 46.18% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 34.24%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB); and one (VZV) vaccines by their second birthday.
Health PlanRateData Collection Method
Molina 77.78% Admin+Chart Review
SelectHealth 84.10% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 57.69%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB); one (VZV); and four (PCV) vaccines by their second birthday.
Health PlanRateData Collection Method
Molina 76.61% Admin+Chart Review
SelectHealth 82.87% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 58.22%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); and one (HepA) vaccines by their second birthday.
Health PlanRateData Collection Method
Molina 75.44% Admin+Chart Review
SelectHealth 81.65% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 56.95%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); and two or three (RV) vaccines by their second birthday.
Health PlanRateData Collection Method
Molina 70.17% Admin+Chart Review
SelectHealth 73.70% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 51.15%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); and two (flu) vaccines by their second birthday.
Health PlanRateData Collection Method
Molina 50.88% Admin+Chart Review
SelectHealth 50.46% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 37.63%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); one (HepA); and two or three (RV) vaccines by their second birthday.
Health PlanRateData Collection Method
Molina 69.59% Admin+Chart Review
SelectHealth 72.78% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 50.47%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); one (HepA); and two (flu) vaccines by their second birthday.
Health PlanRateData Collection Method
Molina 50.88% Admin+Chart Review
SelectHealth 49.85% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 37.26%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); two or three (RV); and two (flu) vaccines by their second birthday.
Health PlanRateData Collection Method
Molina 48.54% Admin+Chart Review
SelectHealth 46.79% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 34.56%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP) vaccines by their second birthday.
Health PlanRateData Collection Method
Molina 85.38% Admin+Chart Review
SelectHealth 87.77% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 70.73%
 
Childhood Immunization Status
The percentage of children 2 years of age who had one (HepA) vaccine by their second birthday.
Health PlanRateData Collection Method
Molina 90.64% Admin+Chart Review
SelectHealth 91.44% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 87.15%
 
Childhood Immunization Status
The percentage of children 2 years of age who had three (HepB) vaccines by their second birthday.
Health PlanRateData Collection Method
Molina 92.97% Admin+Chart Review
SelectHealth 92.97% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 67.31%
 
Childhood Immunization Status
The percentage of children 2 years of age who had three (HiB) vaccines by their second birthday.
Health PlanRateData Collection Method
Molina 93.57% Admin+Chart Review
SelectHealth 93.58% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 80.40%
 
Childhood Immunization Status
The percentage of children 2 years of age who had two (flu) vaccines by their second birthday.
Health PlanRateData Collection Method
Molina 55.55% Admin+Chart Review
SelectHealth 54.13% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 51.87%
 
Childhood Immunization Status
The percentage of children 2 years of age who had three (IPV) vaccines by their second birthday.
Health PlanRateData Collection Method
Molina 92.40% Admin+Chart Review
SelectHealth 93.27% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 78.71%
 
Childhood Immunization Status
The percentage of children 2 years of age who had one (MMR) vaccine by their second birthday.
Health PlanRateData Collection Method
Molina 92.97% Admin+Chart Review
SelectHealth 91.13% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 87.66%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (PCV) vaccines by their second birthday.
Health PlanRateData Collection Method
Molina 87.72% Admin+Chart Review
SelectHealth 88.69% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 71.84%
 
Childhood Immunization Status
The percentage of children 2 years of age who had two or three (RV) vaccines by their second birthday.
Health PlanRateData Collection Method
Molina 77.19% Admin+Chart Review
SelectHealth 81.34% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 65.84%
 
Childhood Immunization Status
The percentage of children 2 years of age who had one (VZV) vaccine by their second birthday.
Health PlanRateData Collection Method
Molina 87.72% Admin+Chart Review
SelectHealth 92.66% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 86.57%
 

Use of Appropriate Medications for People With Asthma
The percentage of members 5-64 years of age with persistent asthma and who were appropriately prescribed medication.
Health PlanRateData Collection Method
SelectHealth 89.09% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 89.76%
 
Asthma Medication Ratio
The percentage of adults and adolescents 5–64 years of age with persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater.
Health PlanRateData Collection Method
SelectHealth 74.55% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 73.69%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 5-64 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 50 percent of the treatment period.
Health PlanRateData Collection Method
SelectHealth 51.02% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 62.50%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 5-64 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 75 percent of the treatment period.
Health PlanRateData Collection Method
SelectHealth 24.49% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 37.35%
 
 
Commercial PPO Measures: 2015

Adults' Access to Preventive/Ambulatory Health Services
The percentage of members 20-44 years and older who had an ambulatory or preventive care visit.
Health PlanRateData Collection Method
PEHP 75.84% Administrative
EMI Health 93.06% Administrative
UnitedHealthCare 92.85% Administrative
Regence BlueCross BlueShield 92.06% Administrative
Aetna 93.97% Administrative
CIGNA 91.64% Administrative
Humana 81.21% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 87.70%
 
Adults' Access to Preventive/Ambulatory Health Services
The percentage of members 45-64 years and older who had an ambulatory or preventive care visit.
Health PlanRateData Collection Method
PEHP 88.45% Administrative
EMI Health 95.98% Administrative
UnitedHealthCare 96.01% Administrative
Regence BlueCross BlueShield 94.86% Administrative
Aetna 96.09% Administrative
CIGNA 95.28% Administrative
Humana 87.00% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 92.61%
 
Adults' Access to Preventive/Ambulatory Health Services
The percentage of members age 65+ years and older who had an ambulatory or preventive care visit.
Health PlanRateData Collection Method
PEHP 89.24% Administrative
EMI Health 97.41% Administrative
UnitedHealthCare 95.71% Administrative
Regence BlueCross BlueShield 96.93% Administrative
Aetna 77.39% Administrative
CIGNA 96.38% Administrative
Humana 91.30% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 90.84%
 
Adults' Access to Preventive/Ambulatory Health Services
The percentage of members 20 years and older who had an ambulatory or preventive care visit.
Health PlanRateData Collection Method
UnitedHealthCare 94.22% Administrative
Regence BlueCross BlueShield 93.77% Administrative
Aetna 93.43% Administrative
CIGNA 93.21% Administrative
Humana 83.41% Administrative
EMI Health 94.54% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 90.34%
 
Call Answer Timeliness
The percentage of calls received by the organization's Member Services call centers (during operating hours) that were answered by a live voice within 30 seconds.
Health PlanRateData Collection Method
UnitedHealthCare 82.00% Administrative
Aetna 75.26% Administrative
Humana 88.79% Administrative
Regence BlueCross BlueShield 66.14% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 81.49%
 
Children and Adolescents' Access to Primary Care Practitioners
The percentage of adolescents 12–19 years who had a visit with a PCP or the year prior to the measurement year.
Health PlanRateData Collection Method
PEHP 65.43% Administrative
EMI Health 82.87% Administrative
UnitedHealthCare 80.72% Administrative
Regence BlueCross BlueShield 81.64% Administrative
Aetna 83.98% Administrative
CIGNA 83.12% Administrative
Humana 76.09% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 83.12%
 
Children and Adolescents' Access to Primary Care Practitioners
The percentage of children 12–24 months who had a visit with a PCP.
Health PlanRateData Collection Method
PEHP 84.27% Administrative
EMI Health 96.34% Administrative
UnitedHealthCare 96.85% Administrative
Regence BlueCross BlueShield 97.56% Administrative
Aetna 97.16% Administrative
CIGNA 97.22% Administrative
Humana 94.29% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 96.40%
 
Children and Adolescents' Access to Primary Care Practitioners
The percentage of children 25 months–6 years who had a visit with a PCP during the measure year.
Health PlanRateData Collection Method
PEHP 71.80% Administrative
EMI Health 81.50% Administrative
UnitedHealthCare 81.47% Administrative
Regence BlueCross BlueShield 84.22% Administrative
Aetna 82.69% Administrative
CIGNA 83.76% Administrative
Humana 76.29% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 83.10%
 
Children and Adolescents' Access to Primary Care Practitioners
The percentage of children 7–11 years who had a visit with a PCP during the measure year or the year prior to the measurement year.
Health PlanRateData Collection Method
PEHP 58.98% Administrative
EMI Health 76.20% Administrative
UnitedHealthCare 78.80% Administrative
Regence BlueCross BlueShield 79.53% Administrative
Aetna 81.39% Administrative
CIGNA 80.31% Administrative
Humana 69.21% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 80.44%
 
Initiation and Engagement of AOD Dependence Treatment
The percentage of members age 13-17 who initiate treatment through an inpatient AOD admission, outpatient visit, intensive outpatient encounter or partial hospitalization within 14 days of the diagnosis.
Health PlanRateData Collection Method
UnitedHealthCare 15.55% Administrative
Aetna 17.95% Administrative
CIGNA 20.00% Administrative
Regence BlueCross BlueShield 10.19% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 17.79%
 
Initiation and Engagement of AOD Dependence Treatment
The percentage of members age 18+ who initiate treatment through an inpatient AOD admission, outpatient visit, intensive outpatient encounter or partial hospitalization within 14 days of the diagnosis.
Health PlanRateData Collection Method
UnitedHealthCare 12.36% Administrative
Regence BlueCross BlueShield 6.95% Administrative
Aetna 15.40% Administrative
CIGNA 20.39% Administrative
Humana 8.21% Administrative
EMI Health 8.09% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 11.29%
 
Initiation and Engagement of AOD Dependence Treatment
The percentage of members who initiate treatment through an inpatient AOD admission, outpatient visit, intensive outpatient encounter or partial hospitalization within 14 days of the diagnosis.
Health PlanRateData Collection Method
UnitedHealthCare 12.59% Administrative
Regence BlueCross BlueShield 7.07% Administrative
Aetna 15.57% Administrative
CIGNA 20.37% Administrative
Humana 8.50% Administrative
EMI Health 8.79% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 11.64%
 
Initiation and Engagement of AOD Dependence Treatment
The percentage of members age 13-17 who initiated treatment and who had two or more additional services with a diagnosis of AOD within 30 days of the initiation visit.
Health PlanRateData Collection Method
UnitedHealthCare 41.11% Administrative
Aetna 46.15% Administrative
CIGNA 48.57% Administrative
Regence BlueCross BlueShield 38.78% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 44.38%
 
Initiation and Engagement of AOD Dependence Treatment
The percentage of members age 18+ who initiated treatment and who had two or more additional services with a diagnosis of AOD within 30 days of the initiation visit.
Health PlanRateData Collection Method
UnitedHealthCare 32.35% Administrative
Regence BlueCross BlueShield 28.37% Administrative
Aetna 38.70% Administrative
CIGNA 39.69% Administrative
Humana 33.56% Administrative
EMI Health 30.06% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 32.55%
 
Initiation and Engagement of AOD Dependence Treatment
The percentage of members who initiated treatment and who had two or more additional services with a diagnosis of AOD within 30 days of the initiation visit.
Health PlanRateData Collection Method
UnitedHealthCare 32.97% Administrative
Regence BlueCross BlueShield 28.78% Administrative
Aetna 39.17% Administrative
CIGNA 40.33% Administrative
Humana 32.68% Administrative
EMI Health 31.86% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 33.19%
 

Immunizations for Adolescents
The percentage of adolescents 13 years of age who had one dose of meningococcal vaccine and one Tdap vaccine or one tetanus, diphtheria toxoids vaccine (Td) by their 13th birthday.
Health PlanRateData Collection Method
PEHP 63.94% Administrative
EMI Health 51.84% Administrative
UnitedHealthCare 60.40% Administrative
Regence BlueCross BlueShield 63.66% Admin+Chart Review
Aetna 63.17% Administrative
CIGNA 55.03% Admin+Chart Review
Humana 64.48% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 66.77%
 
Immunizations for Adolescents
The percentage of adolescents 13 years of age who had one dose of meningococcal vaccine by their 13th birthday.
Health PlanRateData Collection Method
PEHP 63.60% Administrative
EMI Health 54.08% Administrative
UnitedHealthCare 62.08% Administrative
Regence BlueCross BlueShield 64.95% Admin+Chart Review
Aetna 64.64% Administrative
CIGNA 56.28% Admin+Chart Review
Humana 64.95% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 67.66%
 
Immunizations for Adolescents
The percentage of adolescents 13 years of age who had one Tdap vaccine or one tetanus, diphtheria toxoids vaccine (Td) by their 13th birthday.
Health PlanRateData Collection Method
PEHP 89.49% Administrative
EMI Health 74.56% Administrative
UnitedHealthCare 80.43% Administrative
Regence BlueCross BlueShield 85.82% Admin+Chart Review
Aetna 79.33% Administrative
CIGNA 73.87% Admin+Chart Review
Humana 91.24% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 86.45%
 
Human Papillomavirus Vaccine for Female Adolescents
The percentage of female adolescents 13 years of age who had three doses of the HPV vaccine by their 13th birthday.
Health PlanRateData Collection Method
UnitedHealthCare 10.65% Administrative
Regence BlueCross BlueShield 13.13% Admin+Chart Review
Aetna 11.55% Administrative
CIGNA 8.66% Admin+Chart Review
Humana 9.49% Admin+Chart Review
EMI Health 8.16% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 16.63%
 

Comprehensive Diabetes Care
The percentage of adults 18–75 years of age with diabetes (type 1 and type 2) who had BP control (<140/90 mm Hg).
Health PlanRateData Collection Method
UnitedHealthCare 59.53% Admin+Chart Review
CIGNA 0.00% Admin+Chart Review
Humana 53.66% Admin+Chart Review
EMI Health 0.20% Administrative
Regence BlueCross BlueShield 62.29% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 51.36%
 
Comprehensive Diabetes Care
The percentage of adults 18–75 years of age with diabetes (type 1 and type 2) who had an eye exam (retinal) performed.
Health PlanRateData Collection Method
PEHP 41.29% Administrative
EMI Health 45.49% Administrative
UnitedHealthCare 45.18% Admin+Chart Review
Regence BlueCross BlueShield 54.01% Admin+Chart Review
Aetna 34.81% Administrative
CIGNA 31.29% Admin+Chart Review
Humana 35.32% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 49.74%
 
Comprehensive Diabetes Care
The percentage of adults 18–75 years of age with diabetes (type 1 and type 2) who had HbA1c control (<7.0%) for a selected population.
Health PlanRateData Collection Method
CIGNA 5.73% Admin+Chart Review
Humana 35.35% Admin+Chart Review
EMI Health 6.35% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 21.90%
 
Comprehensive Diabetes Care
The percentage of adults 18–75 years of age with diabetes (type 1 and type 2) who had HbA1c control (<8.0%).
Health PlanRateData Collection Method
PEHP 68.31% Administrative
Regence BlueCross BlueShield 46.23% Admin+Chart Review
UnitedHealthCare 48.71% Admin+Chart Review
CIGNA 8.82% Admin+Chart Review
Humana 49.54% Admin+Chart Review
EMI Health 8.70% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 45.30%
 
Comprehensive Diabetes Care
The percentage of adults 18–75 years of age with diabetes (type 1 and type 2) who had HbA1c poor control (>9.0%).
Health PlanRateData Collection Method
UnitedHealthCare 43.05% Admin+Chart Review
CIGNA 89.45% Admin+Chart Review
Humana 47.25% Admin+Chart Review
EMI Health 89.87% Administrative
Regence BlueCross BlueShield 42.34% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 48.69%
 
Comprehensive Diabetes Care
The percentage of adults 18–75 years of age with diabetes (type 1 and type 2) who had Hemoglobin A1c (HbA1c) testing.
Health PlanRateData Collection Method
PEHP 87.90% Administrative
EMI Health 87.64% Administrative
UnitedHealthCare 89.88% Admin+Chart Review
Regence BlueCross BlueShield 85.40% Admin+Chart Review
Aetna 87.17% Administrative
CIGNA 90.47% Admin+Chart Review
Humana 87.61% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 88.17%
 
Comprehensive Diabetes Care
The percentage of adults 18–75 years of age with diabetes (type 1 and type 2) who had medical attention for nephropathy.
Health PlanRateData Collection Method
PEHP 85.61% Administrative
EMI Health 80.55% Administrative
UnitedHealthCare 78.34% Admin+Chart Review
Regence BlueCross BlueShield 83.70% Admin+Chart Review
Aetna 71.20% Administrative
CIGNA 74.02% Admin+Chart Review
Humana 73.39% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 80.10%
 

Appropriate Testing for Children with Pharyngitis
The percentage of children 2-18 years of age who were diagnosed with pharyngitis and dispensed an antibiotic, and received a group A streptococcus test for the episode.
Health PlanRateData Collection Method
PEHP 80.19% Administrative
EMI Health 82.37% Administrative
UnitedHealthCare 88.07% Administrative
Regence BlueCross BlueShield 83.75% Administrative
Aetna 90.41% Administrative
CIGNA 84.95% Administrative
Humana 88.48% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 81.67%
 

Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had no well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
UnitedHealthCare 2.15% Administrative
Regence BlueCross BlueShield 1.60% Administrative
Aetna 1.44% Administrative
CIGNA 2.04% Administrative
Humana 4.32% Administrative
EMI Health 1.20% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 1.63%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had one well-child visit with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
UnitedHealthCare 2.62% Administrative
Regence BlueCross BlueShield 1.65% Administrative
Aetna 1.12% Administrative
CIGNA 1.21% Administrative
Humana 1.65% Administrative
EMI Health 2.40% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 1.68%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had two well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
UnitedHealthCare 2.06% Administrative
Regence BlueCross BlueShield 1.44% Administrative
Aetna 1.23% Administrative
CIGNA 2.41% Administrative
Humana 2.46% Administrative
EMI Health 0.48% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 1.56%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had three well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
UnitedHealthCare 4.18% Administrative
Regence BlueCross BlueShield 3.04% Administrative
Aetna 1.75% Administrative
CIGNA 3.26% Administrative
Humana 4.93% Administrative
EMI Health 1.92% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 3.29%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had four well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
UnitedHealthCare 11.49% Administrative
Regence BlueCross BlueShield 6.90% Administrative
Aetna 5.02% Administrative
CIGNA 4.46% Administrative
Humana 6.58% Administrative
EMI Health 7.21% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 7.92%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had five well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
UnitedHealthCare 23.33% Administrative
Regence BlueCross BlueShield 17.09% Administrative
Aetna 11.29% Administrative
CIGNA 15.32% Administrative
Humana 21.19% Administrative
EMI Health 14.18% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 18.39%
 
Well-Child Visits In The First 15 Months of Life
The percentage of children who turned 15 months old and had at least six well-child visits with a primary care physician during their first 15 months of life.
Health PlanRateData Collection Method
PEHP 80.29% Administrative
EMI Health 72.59% Administrative
UnitedHealthCare 54.16% Administrative
Regence BlueCross BlueShield 68.30% Administrative
Aetna 78.13% Administrative
CIGNA 71.29% Administrative
Humana 58.85% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 66.47%
 
Adolescent Well-Care Visits
The percentage of eolled adolescents and young adults 12–21 years of age who had at least one comprehensive well-care visit with a primary care practitioner or an OB/GYN practitioner.
Health PlanRateData Collection Method
PEHP 19.13% Administrative
EMI Health 32.84% Administrative
UnitedHealthCare 31.58% Administrative
Regence BlueCross BlueShield 32.40% Administrative
Aetna 30.35% Administrative
CIGNA 32.17% Administrative
Humana 33.68% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 35.71%
 
Appropriate Treatment for Children With Upper Respiratory Infection (URI)
The percentage of children 3 months-18 years of age who were given a diagnosis of URI and were not dispensed an antibiotic prescription.
Health PlanRateData Collection Method
PEHP 85.46% Administrative
EMI Health 85.17% Administrative
UnitedHealthCare 89.05% Administrative
Regence BlueCross BlueShield 86.93% Administrative
Aetna 88.76% Administrative
CIGNA 89.84% Administrative
Humana 86.20% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 89.75%
 
Follow-Up Care for Children Prescribed ADHD Medication
The percentage of children between 6 and 12 years of age who had a prescription for ADHD medication and remained on it for at least 210 days, and had at least two follow-up visits in the 9 months subsequent to the Initiation Phase.
Health PlanRateData Collection Method
UnitedHealthCare 48.33% Administrative
Aetna 35.48% Administrative
CIGNA 45.00% Administrative
EMI Health 32.43% Administrative
Regence BlueCross BlueShield 37.93% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 37.12%
 
Follow-Up Care for Children Prescribed ADHD Medication
The percentage of children between 6 and 12 years of age who were diagnosed with ADHD and had one follow-up visit with a practitioner with prescribing authority, within 30 days of their first prescription of ADHD medication.
Health PlanRateData Collection Method
UnitedHealthCare 37.79% Administrative
Regence BlueCross BlueShield 24.49% Administrative
Aetna 32.61% Administrative
CIGNA 41.44% Administrative
Humana 27.63% Administrative
EMI Health 27.02% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 33.85%
 
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
The percentage of children 3–17 years of age who had an outpatient visit with a primary care practitioner or OB/GYN and who had evidence of BMI percentile documentation.
Health PlanRateData Collection Method
UnitedHealthCare 0.44% Administrative
CIGNA 0.27% Admin+Chart Review
Humana 26.76% Admin+Chart Review
EMI Health 0.54% Administrative
Regence BlueCross BlueShield 42.58% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 40.57%
 
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
The percentage of children 3–17 years of age who had an outpatient visit with a primary care practitioner or OB/GYN and who had evidence of counseling for nutrition.
Health PlanRateData Collection Method
UnitedHealthCare 0.40% Administrative
CIGNA 0.35% Admin+Chart Review
Humana 36.01% Admin+Chart Review
EMI Health 0.20% Administrative
Regence BlueCross BlueShield 48.42% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 35.86%
 
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
The percentage of children 3–17 years of age who had an outpatient visit with a primary care practitioner or OB/GYN and who had evidence of counseling for physical activity.
Health PlanRateData Collection Method
UnitedHealthCare 0.19% Administrative
CIGNA 0.17% Admin+Chart Review
Humana 25.79% Admin+Chart Review
EMI Health 0.08% Administrative
Regence BlueCross BlueShield 40.15% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 31.77%
 
Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life
The percentage of children 3–6 years of age who received one or more well-child visits with a primary care practitioner.
Health PlanRateData Collection Method
PEHP 39.65% Administrative
EMI Health 60.50% Administrative
UnitedHealthCare 59.12% Administrative
Regence BlueCross BlueShield 61.82% Administrative
Aetna 61.18% Administrative
CIGNA 61.37% Administrative
Humana 56.46% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 60.08%
 

Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); one (HepA); two or three (RV); and two (flu) vaccines by their second birthday.
Health PlanRateData Collection Method
UnitedHealthCare 46.98% Admin+Chart Review
Regence BlueCross BlueShield 47.45% Admin+Chart Review
Aetna 16.11% Administrative
CIGNA 10.42% Admin+Chart Review
Humana 36.01% Admin+Chart Review
EMI Health 6.64% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 34.24%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB); and one (VZV) vaccines by their second birthday.
Health PlanRateData Collection Method
PEHP 28.77% Administrative
EMI Health 15.63% Administrative
UnitedHealthCare 77.44% Admin+Chart Review
Regence BlueCross BlueShield 72.50% Admin+Chart Review
Aetna 25.52% Administrative
CIGNA 17.07% Admin+Chart Review
Humana 63.02% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 57.69%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB); one (VZV); and four (PCV) vaccines by their second birthday.
Health PlanRateData Collection Method
PEHP 27.68% Administrative
Regence BlueCross BlueShield 70.56% Admin+Chart Review
UnitedHealthCare 76.73% Admin+Chart Review
CIGNA 16.70% Admin+Chart Review
Humana 60.34% Admin+Chart Review
EMI Health 13.91% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 58.22%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); and one (HepA) vaccines by their second birthday.
Health PlanRateData Collection Method
UnitedHealthCare 74.65% Admin+Chart Review
Regence BlueCross BlueShield 69.09% Admin+Chart Review
Aetna 23.98% Administrative
CIGNA 15.93% Admin+Chart Review
Humana 59.12% Admin+Chart Review
EMI Health 13.28% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 56.95%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); and two or three (RV) vaccines by their second birthday.
Health PlanRateData Collection Method
UnitedHealthCare 68.84% Admin+Chart Review
Regence BlueCross BlueShield 65.21% Admin+Chart Review
Aetna 22.44% Administrative
CIGNA 15.54% Admin+Chart Review
Humana 54.50% Admin+Chart Review
EMI Health 11.55% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 51.15%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); and two (flu) vaccines by their second birthday.
Health PlanRateData Collection Method
UnitedHealthCare 50.93% Admin+Chart Review
Regence BlueCross BlueShield 50.84% Admin+Chart Review
Aetna 17.19% Administrative
CIGNA 11.20% Admin+Chart Review
Humana 39.66% Admin+Chart Review
EMI Health 7.28% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 37.63%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); one (HepA); and two or three (RV) vaccines by their second birthday.
Health PlanRateData Collection Method
UnitedHealthCare 66.97% Admin+Chart Review
Regence BlueCross BlueShield 64.23% Admin+Chart Review
Aetna 22.17% Administrative
CIGNA 14.85% Admin+Chart Review
Humana 53.53% Admin+Chart Review
EMI Health 11.13% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 50.47%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); one (HepA); and two (flu) vaccines by their second birthday.
Health PlanRateData Collection Method
UnitedHealthCare 50.47% Admin+Chart Review
Regence BlueCross BlueShield 50.12% Admin+Chart Review
Aetna 17.01% Administrative
CIGNA 10.81% Admin+Chart Review
Humana 38.93% Admin+Chart Review
EMI Health 6.85% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 37.26%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP); three (IPV); one (MMR); three (HiB); three (HepB), one (VZV); four (PCV); two or three (RV); and two (flu) vaccines by their second birthday.
Health PlanRateData Collection Method
UnitedHealthCare 47.44% Admin+Chart Review
Regence BlueCross BlueShield 48.18% Admin+Chart Review
Aetna 16.29% Administrative
CIGNA 10.81% Admin+Chart Review
Humana 36.50% Admin+Chart Review
EMI Health 7.07% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 34.56%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (DTaP) vaccines by their second birthday.
Health PlanRateData Collection Method
PEHP 64.68% Administrative
EMI Health 49.46% Administrative
UnitedHealthCare 81.16% Admin+Chart Review
Regence BlueCross BlueShield 81.27% Admin+Chart Review
Aetna 60.09% Administrative
CIGNA 50.58% Admin+Chart Review
Humana 70.80% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 70.73%
 
Childhood Immunization Status
The percentage of children 2 years of age who had one (HepA) vaccine by their second birthday.
Health PlanRateData Collection Method
UnitedHealthCare 88.14% Admin+Chart Review
Regence BlueCross BlueShield 88.81% Admin+Chart Review
Aetna 85.79% Administrative
CIGNA 83.88% Admin+Chart Review
Humana 80.54% Admin+Chart Review
EMI Health 81.80% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 87.15%
 
Childhood Immunization Status
The percentage of children 2 years of age who had three (HepB) vaccines by their second birthday.
Health PlanRateData Collection Method
PEHP 34.95% Administrative
EMI Health 19.05% Administrative
UnitedHealthCare 89.77% Admin+Chart Review
Regence BlueCross BlueShield 86.13% Admin+Chart Review
Aetna 30.23% Administrative
CIGNA 19.50% Admin+Chart Review
Humana 77.62% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 67.31%
 
Childhood Immunization Status
The percentage of children 2 years of age who had three (HiB) vaccines by their second birthday.
Health PlanRateData Collection Method
PEHP 78.48% Administrative
EMI Health 57.82% Administrative
UnitedHealthCare 92.33% Admin+Chart Review
Regence BlueCross BlueShield 91.47% Admin+Chart Review
Aetna 70.23% Administrative
CIGNA 61.00% Admin+Chart Review
Humana 81.51% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 80.40%
 
Childhood Immunization Status
The percentage of children 2 years of age who had two (flu) vaccines by their second birthday.
Health PlanRateData Collection Method
UnitedHealthCare 57.21% Admin+Chart Review
Regence BlueCross BlueShield 61.56% Admin+Chart Review
Aetna 52.94% Administrative
CIGNA 47.49% Admin+Chart Review
Humana 50.12% Admin+Chart Review
EMI Health 43.47% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 51.87%
 
Childhood Immunization Status
The percentage of children 2 years of age who had three (IPV) vaccines by their second birthday.
Health PlanRateData Collection Method
PEHP 75.14% Administrative
EMI Health 55.88% Administrative
UnitedHealthCare 91.16% Admin+Chart Review
Regence BlueCross BlueShield 90.51% Admin+Chart Review
Aetna 66.14% Administrative
CIGNA 56.85% Admin+Chart Review
Humana 80.28% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 78.71%
 
Childhood Immunization Status
The percentage of children 2 years of age who had one (MMR) vaccine by their second birthday.
Health PlanRateData Collection Method
PEHP 85.17% Administrative
EMI Health 79.23% Administrative
UnitedHealthCare 89.07% Admin+Chart Review
Regence BlueCross BlueShield 90.51% Admin+Chart Review
Aetna 84.25% Administrative
CIGNA 82.43% Admin+Chart Review
Humana 82.00% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 87.66%
 
Childhood Immunization Status
The percentage of children 2 years of age who had four (PCV) vaccines by their second birthday.
Health PlanRateData Collection Method
PEHP 66.71% Administrative
EMI Health 50.11% Administrative
UnitedHealthCare 86.28% Admin+Chart Review
Regence BlueCross BlueShield 82.48% Admin+Chart Review
Aetna 59.73% Administrative
CIGNA 50.19% Admin+Chart Review
Humana 73.24% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 71.84%
 
Childhood Immunization Status
The percentage of children 2 years of age who had two or three (RV) vaccines by their second birthday.
Health PlanRateData Collection Method
UnitedHealthCare 80.00% Admin+Chart Review
Regence BlueCross BlueShield 81.02% Admin+Chart Review
Aetna 59.46% Administrative
CIGNA 48.84% Admin+Chart Review
Humana 68.13% Admin+Chart Review
EMI Health 46.90% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 65.84%
 
Childhood Immunization Status
The percentage of children 2 years of age who had one (VZV) vaccine by their second birthday.
Health PlanRateData Collection Method
PEHP 83.50% Administrative
EMI Health 77.52% Administrative
UnitedHealthCare 88.37% Admin+Chart Review
Regence BlueCross BlueShield 88.08% Admin+Chart Review
Aetna 83.26% Administrative
CIGNA 81.76% Admin+Chart Review
Humana 82.00% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 86.57%
 

Colorectal Cancer Screening
The percentage of adults 50–75 years of age who had appropriate screening for colorectal cancer with any of the following tests: annual fecal occult blood test; flexible sigmoidoscopy every five years; or colonoscopy every ten years.
Health PlanRateData Collection Method
PEHP 34.55% Administrative
EMI Health 46.71% Administrative
UnitedHealthCare 65.53% Admin+Chart Review
Regence BlueCross BlueShield 62.76% Admin+Chart Review
Aetna 57.18% Administrative
CIGNA 44.43% Admin+Chart Review
Humana 47.20% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 56.01%
 
Use of Imaging Studies for Low Back Pain
The percentage of adults 18-50 years of age with a primary diagnosis of low back pain who did not have an imaging study (plain X-ray, MRI or CT scan) within 28 days of the diagnosis.
Health PlanRateData Collection Method
PEHP 81.26% Administrative
EMI Health 83.43% Administrative
UnitedHealthCare 81.17% Administrative
Regence BlueCross BlueShield 75.64% Administrative
Aetna 81.05% Administrative
CIGNA 80.02% Administrative
Humana 74.85% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 79.02%
 
Controlling High Blood Pressure
The percentage of adults 18–85 years of age who had a diagnosis of hypertension and whose blood pressure was adequately controlled.
Health PlanRateData Collection Method
UnitedHealthCare 57.68% Admin+Chart Review
CIGNA 0.00% Admin+Chart Review
Humana 48.78% Admin+Chart Review
Regence BlueCross BlueShield 53.04% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 54.30%
 
Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis
The percentage of adults 18-64 years of age with a diagnosis of acute bronchitis who were not dispensed an antibiotic prescription.
Health PlanRateData Collection Method
PEHP 35.39% Administrative
EMI Health 30.09% Administrative
UnitedHealthCare 36.21% Administrative
Regence BlueCross BlueShield 29.54% Administrative
Aetna 36.25% Administrative
CIGNA 27.52% Administrative
Humana 27.48% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 35.94%
 
Adult BMI Assessment
The percentage of adults 18–74 years of age who had an outpatient visit and whose BMI was documented in the past two years.
Health PlanRateData Collection Method
UnitedHealthCare 3.68% Administrative
Regence BlueCross BlueShield 80.53% Admin+Chart Review
Aetna 8.06% Administrative
CIGNA 2.37% Admin+Chart Review
Humana 59.27% Admin+Chart Review
EMI Health 1.98% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 51.26%
 
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis
The percentage of adults diagnosed with RA who were dispensed at least one ambulatory prescription for a DMARD.
Health PlanRateData Collection Method
UnitedHealthCare 91.36% Administrative
Aetna 85.29% Administrative
CIGNA 93.88% Administrative
EMI Health 84.61% Administrative
Regence BlueCross BlueShield 89.79% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 79.02%
 
Use of Spirometry Testing in the Assessment and Diagnosis of COPD
The percentage of adults 40 years of age and older with a new diagnosis of COPD or newly active COPD, who received spirometry testing to confirm the diagnosis.
Health PlanRateData Collection Method
UnitedHealthCare 37.84% Administrative
Aetna 40.66% Administrative
CIGNA 45.00% Administrative
EMI Health 35.00% Administrative
Regence BlueCross BlueShield 39.86% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 37.21%
 

Follow-Up After Hospitalization for Mental Illness
The percentage of discharges for members 6 years of age and older who were hospitalized for treatment of selected mental health disorders and had a visit with a mental health practitioner within 30 days of discharge.
Health PlanRateData Collection Method
UnitedHealthCare 76.11% Administrative
Regence BlueCross BlueShield 69.52% Administrative
Aetna 66.41% Administrative
CIGNA 55.91% Administrative
Humana 40.38% Administrative
EMI Health 70.93% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 64.94%
 
Follow-Up After Hospitalization for Mental Illness
The percentage of discharges for members 6 years of age and older who were hospitalized for treatment of selected mental health disorders and had a visit with a mental health practitioner within 7 days of discharge.
Health PlanRateData Collection Method
UnitedHealthCare 57.74% Administrative
Regence BlueCross BlueShield 51.00% Administrative
Aetna 49.24% Administrative
CIGNA 39.78% Administrative
Humana 25.00% Administrative
EMI Health 45.35% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 45.89%
 
Metabolic Monitoring for children on Antipsychotics
The percentage of children 12-17 years of age who had two or more antipsychotic prescriptions and had metabolic testing.
Health PlanRateData Collection Method
Aetna 32.72% Administrative
CIGNA 20.41% Administrative
Regence BlueCross BlueShield 18.02% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 27.59%
 
Metabolic Monitoring for children on Antipsychotics
The percentage of children 1-5 years of age who had two or more antipsychotic prescriptions and had metabolic testing.
Health PlanRateData Collection Method
CIGNA 0.00% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 0.00%
 
Metabolic Monitoring for children on Antipsychotics
The percentage of children 6-11 years of age who had two or more antipsychotic prescriptions and had metabolic testing.
Health PlanRateData Collection Method
CIGNA 25.00% Administrative
Regence BlueCross BlueShield 11.89% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 23.32%
 
Metabolic Monitoring for children on Antipsychotics
The percentage of children 1-17 years of age who had two or more antipsychotic prescriptions and had metabolic testing.
Health PlanRateData Collection Method
Aetna 31.08% Administrative
CIGNA 21.31% Administrative
EMI Health 20.00% Administrative
Regence BlueCross BlueShield 16.46% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 26.31%
 
Use of First-Line Psychosocial Care for children on Antipsychotics
The percentage of children 12-17 years of age who had a new prescription for an antipsychotic medication and had documentation of psychological care as first-line treatment.
Health PlanRateData Collection Method
CIGNA 30.00% Administrative
Regence BlueCross BlueShield 77.27% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 51.82%
 
Use of First-Line Psychosocial Care for children on Antipsychotics
The percentage of children 1-5 years of age who had a new prescription for an antipsychotic medication and had documentation of psychological care as first-line treatment.
Health PlanRateData Collection Method
CIGNA 0.00% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 0.00%
 
Use of First-Line Psychosocial Care for children on Antipsychotics
The percentage of children 6-11 years of age who had a new prescription for an antipsychotic medication and had documentation of psychological care as first-line treatment.
Health PlanRateData Collection Method
CIGNA 66.67% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 50.61%
 
Use of First-Line Psychosocial Care for children on Antipsychotics
The percentage of children 1-17 years of age who had a new prescription for an antipsychotic medication and had documentation of psychological care as first-line treatment.
Health PlanRateData Collection Method
Aetna 45.45% Administrative
CIGNA 34.78% Administrative
Regence BlueCross BlueShield 64.18% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 47.10%
 
Use of Multiple Concurrent Antipsychotics in Children and Adolescents
The percentage of children 12-17 years of age who were on two or more concurrent antipsychotic medications.
Health PlanRateData Collection Method
Aetna 13.16% Administrative
CIGNA 4.55% Administrative
Regence BlueCross BlueShield 3.00% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 6.34%
 
Use of Multiple Concurrent Antipsychotics in Children and Adolescents
The percentage of children 1-5 years of age who were on two or more concurrent antipsychotic medications.
Health PlanRateData Collection Method
CIGNA 0.00% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 0.00%
 
Use of Multiple Concurrent Antipsychotics in Children and Adolescents
The percentage of children 6-11 years of age who were on two or more concurrent antipsychotic medications.
Health PlanRateData Collection Method
CIGNA 0.00% Administrative
Regence BlueCross BlueShield 0.00% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 3.13%
 
Use of Multiple Concurrent Antipsychotics in Children and Adolescents
The percentage of children 1-17 years of age who were on two or more concurrent antipsychotic medications.
Health PlanRateData Collection Method
Aetna 15.09% Administrative
CIGNA 3.70% Administrative
Regence BlueCross BlueShield 2.31% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 6.39%
 

Use of Appropriate Medications for People With Asthma
The percentage of members 12-18 years of age with persistent asthma and who were appropriately prescribed medication.
Health PlanRateData Collection Method
UnitedHealthCare 88.54% Administrative
Aetna 95.65% Administrative
CIGNA 89.66% Administrative
Humana 96.88% Administrative
Regence BlueCross BlueShield 95.41% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 90.77%
 
Use of Appropriate Medications for People With Asthma
The percentage of members 19-50 years of age with persistent asthma and who were appropriately prescribed medication.
Health PlanRateData Collection Method
UnitedHealthCare 85.93% Administrative
Regence BlueCross BlueShield 89.63% Administrative
Aetna 90.85% Administrative
CIGNA 86.51% Administrative
Humana 84.91% Administrative
EMI Health 83.82% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 84.26%
 
Use of Appropriate Medications for People With Asthma
The percentage of members 5-11 years of age with persistent asthma and who were appropriately prescribed medication.
Health PlanRateData Collection Method
PEHP 97.65% Administrative
UnitedHealthCare 100.00% Administrative
Aetna 100.00% Administrative
CIGNA 100.00% Administrative
Regence BlueCross BlueShield 97.48% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 96.27%
 
Use of Appropriate Medications for People With Asthma
The percentage of members 51-64 years of age with persistent asthma and who were appropriately prescribed medication.
Health PlanRateData Collection Method
UnitedHealthCare 92.42% Administrative
Aetna 97.10% Administrative
CIGNA 93.44% Administrative
EMI Health 94.74% Administrative
Regence BlueCross BlueShield 92.58% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 87.27%
 
Use of Appropriate Medications for People With Asthma
The percentage of members 5-64 years of age with persistent asthma and who were appropriately prescribed medication.
Health PlanRateData Collection Method
PEHP 91.30% Administrative
EMI Health 90.57% Administrative
UnitedHealthCare 90.38% Administrative
Regence BlueCross BlueShield 92.11% Administrative
Aetna 94.59% Administrative
CIGNA 90.73% Administrative
Humana 92.54% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 89.76%
 
Persistence of Beta-Blocker Treatment After a Heart Attack
The percentage of adults 18 years of age and older who were hospitalized and discharged alive with a diagnosis of acute myocardial infarction and who received persistent beta-blocker treatment for six months after discharge.
Health PlanRateData Collection Method
UnitedHealthCare 70.00% Administrative
CIGNA 44.44% Administrative
Regence BlueCross BlueShield 81.47% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 70.77%
 
Asthma Medication Ratio
The percentage of adults and adolescents 12-18 years of age with persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater.
Health PlanRateData Collection Method
UnitedHealthCare 71.28% Administrative
Aetna 78.25% Administrative
CIGNA 65.52% Administrative
Humana 84.38% Administrative
Regence BlueCross BlueShield 80.73% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 71.47%
 
Asthma Medication Ratio
The percentage of adults and adolescents 19-50 years of age with persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater.
Health PlanRateData Collection Method
UnitedHealthCare 69.52% Administrative
Regence BlueCross BlueShield 69.55% Administrative
Aetna 75.89% Administrative
CIGNA 69.84% Administrative
Humana 64.14% Administrative
EMI Health 73.53% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 65.27%
 
Asthma Medication Ratio
The percentage of adults and adolescents 5-11 years of age with persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater.
Health PlanRateData Collection Method
UnitedHealthCare 91.30% Administrative
Aetna 89.47% Administrative
CIGNA 97.67% Administrative
Regence BlueCross BlueShield 88.98% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 84.18%
 
Asthma Medication Ratio
The percentage of adults and adolescents 51-64 years of age with persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater.
Health PlanRateData Collection Method
UnitedHealthCare 78.79% Administrative
Aetna 79.71% Administrative
CIGNA 90.00% Administrative
EMI Health 91.23% Administrative
Regence BlueCross BlueShield 83.05% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 76.29%
 
Asthma Medication Ratio
The percentage of adults and adolescents 5–64 years of age with persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater.
Health PlanRateData Collection Method
UnitedHealthCare 75.90% Administrative
Regence BlueCross BlueShield 77.16% Administrative
Aetna 79.55% Administrative
CIGNA 78.68% Administrative
Humana 77.44% Administrative
EMI Health 83.02% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 73.69%
 
Antidepressant Medication Management
The percentage of adults 18 years of age and older with a diagnosis of major depression, who were newly treated with antidepressant medication and remained on an antidepressant medication for at least 84 days (12 weeks).
Health PlanRateData Collection Method
UnitedHealthCare 59.41% Administrative
Regence BlueCross BlueShield 63.50% Administrative
Aetna 71.85% Administrative
CIGNA 63.52% Administrative
Humana 64.29% Administrative
EMI Health 71.06% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 61.47%
 
Antidepressant Medication Management
The percentage of adults 18 years of age and older with a diagnosis of major depression, who were newly treated with antidepressant medication and remained on an antidepressant medication for at least 180 days (6 months).
Health PlanRateData Collection Method
UnitedHealthCare 44.37% Administrative
Regence BlueCross BlueShield 47.58% Administrative
Aetna 59.90% Administrative
CIGNA 44.28% Administrative
Humana 43.14% Administrative
EMI Health 56.33% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 45.38%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 12-18 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 50 percent of the treatment period.
Health PlanRateData Collection Method
UnitedHealthCare 50.59% Administrative
Aetna 68.17% Administrative
CIGNA 50.00% Administrative
Humana 51.61% Administrative
Regence BlueCross BlueShield 65.38% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 55.05%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 12-18 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 75 percent of the treatment period.
Health PlanRateData Collection Method
UnitedHealthCare 24.70% Administrative
Aetna 43.18% Administrative
CIGNA 26.92% Administrative
Humana 22.58% Administrative
Regence BlueCross BlueShield 36.54% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 29.50%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 19-50 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 50 percent of the treatment period.
Health PlanRateData Collection Method
UnitedHealthCare 61.21% Administrative
Regence BlueCross BlueShield 62.89% Administrative
Aetna 73.64% Administrative
CIGNA 66.06% Administrative
Humana 64.44% Administrative
EMI Health 78.95% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 63.75%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 19-50 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 75 percent of the treatment period.
Health PlanRateData Collection Method
UnitedHealthCare 34.91% Administrative
Regence BlueCross BlueShield 40.47% Administrative
Aetna 44.96% Administrative
CIGNA 42.20% Administrative
Humana 26.67% Administrative
EMI Health 50.88% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 37.76%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 5-11 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 50 percent of the treatment period.
Health PlanRateData Collection Method
UnitedHealthCare 60.87% Administrative
Aetna 75.44% Administrative
CIGNA 65.12% Administrative
Regence BlueCross BlueShield 56.89% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 59.37%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 5-11 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 75 percent of the treatment period.
Health PlanRateData Collection Method
UnitedHealthCare 35.65% Administrative
Aetna 52.63% Administrative
CIGNA 34.88% Administrative
Regence BlueCross BlueShield 33.61% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 33.45%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 51-64 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 50 percent of the treatment period.
Health PlanRateData Collection Method
UnitedHealthCare 73.77% Administrative
Aetna 77.61% Administrative
CIGNA 84.21% Administrative
EMI Health 88.89% Administrative
Regence BlueCross BlueShield 73.45% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 74.92%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 51-64 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 75 percent of the treatment period.
Health PlanRateData Collection Method
UnitedHealthCare 54.10% Administrative
Aetna 55.22% Administrative
CIGNA 57.89% Administrative
EMI Health 74.07% Administrative
Regence BlueCross BlueShield 47.64% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 55.28%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 5-64 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 50 percent of the treatment period.
Health PlanRateData Collection Method
UnitedHealthCare 62.27% Administrative
Regence BlueCross BlueShield 65.60% Administrative
Aetna 74.07% Administrative
CIGNA 68.51% Administrative
Humana 61.29% Administrative
EMI Health 81.25% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 62.50%
 
Medication Management for People with Asthma
The percentage of adults and adolescents 5-64 years of age with persistent asthma and were dispensed appropriate asthma controller medications that they remained on for at least 75 percent of the treatment period.
Health PlanRateData Collection Method
UnitedHealthCare 37.73% Administrative
Regence BlueCross BlueShield 41.32% Administrative
Aetna 48.48% Administrative
CIGNA 42.98% Administrative
Humana 30.65% Administrative
EMI Health 57.64% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 37.35%
 
Annual Monitoring for Patients on Persistent Medications
The percentage of adults 18 and older who received at least 180 treatment days of ambulatory medication therapy for angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARB).
Health PlanRateData Collection Method
UnitedHealthCare 80.02% Administrative
Regence BlueCross BlueShield 78.32% Administrative
Aetna 79.65% Administrative
CIGNA 80.38% Administrative
Humana 73.56% Administrative
EMI Health 72.65% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 80.23%
 
Annual Monitoring for Patients on Persistent Medications
The percentage of adults 18 and older who received at least 180 treatment days of ambulatory medication therapy for digoxin.
Health PlanRateData Collection Method
CIGNA 25.00% Administrative
Regence BlueCross BlueShield 42.37% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 39.01%
 
Annual Monitoring for Patients on Persistent Medications
The percentage of adults 18 and older who received at least 180 treatment days of ambulatory medication therapy for diuretics.
Health PlanRateData Collection Method
UnitedHealthCare 77.64% Administrative
Regence BlueCross BlueShield 77.28% Administrative
Aetna 77.31% Administrative
CIGNA 79.30% Administrative
Humana 71.19% Administrative
EMI Health 70.62% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 78.64%
 
Annual Monitoring for Patients on Persistent Medications
The percentage of adults 18 and older who received at least 180 treatment days of ambulatory medication therapy for a select therapeutic agent and at least one therapeutic monitoring event for the therapeutic agent.
Health PlanRateData Collection Method
UnitedHealthCare 78.84% Administrative
Regence BlueCross BlueShield 77.73% Administrative
Aetna 78.60% Administrative
CIGNA 79.81% Administrative
Humana 72.31% Administrative
EMI Health 71.84% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 79.40%
 
Pharmacotherapy Management of COPD Exacerbation
The percentage of COPD exacerbations for adults 40 years and older who had an inpatient or ED visit with a primary discharge diagnosis of COPD and were dispensed a bronchodilator within 30 days of the event.
Health PlanRateData Collection Method
CIGNA 81.81% Administrative
Regence BlueCross BlueShield 66.67% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 66.57%
 
Pharmacotherapy Management of COPD Exacerbation
The percentage of COPD exacerbations for adults 40 years and older who had an inpatient or ED visit with a primary discharge diagnosis of COPD and were dispensed a systemic corticosteroid within 14 days of the event.
Health PlanRateData Collection Method
CIGNA 63.63% Administrative
Regence BlueCross BlueShield 64.29% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 54.21%
 

Breast Cancer Screening
The percentage of women 50–74 years of age who had at least one mammogram to screen for breast cancer in the past two years.
Health PlanRateData Collection Method
PEHP 63.67% Administrative
EMI Health 66.23% Administrative
UnitedHealthCare 65.23% Administrative
Regence BlueCross BlueShield 61.97% Administrative
Aetna 61.55% Administrative
CIGNA 65.03% Administrative
Humana 62.32% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 61.42%
 
Cervical Cancer Screening
The percentage of women 21–64 years of age who were screened for cervical cancer.
Health PlanRateData Collection Method
PEHP 56.53% Administrative
EMI Health 58.08% Administrative
UnitedHealthCare 68.63% Administrative
Regence BlueCross BlueShield 68.66% Admin+Chart Review
Aetna 68.66% Administrative
CIGNA 67.03% Admin+Chart Review
Humana 66.58% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 62.13%
 
Chlamydia Screening in Women
The percentage of women 16–20 years of age who were identified as sexually active and who had at least one test for chlamydia.
Health PlanRateData Collection Method
UnitedHealthCare 28.62% Administrative
Regence BlueCross BlueShield 27.52% Administrative
Aetna 30.61% Administrative
CIGNA 29.21% Administrative
Humana 18.09% Administrative
EMI Health 19.67% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 27.45%
 
Chlamydia Screening in Women
The percentage of women 21–24 years of age who were identified as sexually active and who had at least one test for chlamydia.
Health PlanRateData Collection Method
UnitedHealthCare 35.41% Administrative
Regence BlueCross BlueShield 33.46% Administrative
Aetna 34.32% Administrative
CIGNA 35.15% Administrative
Humana 22.95% Administrative
EMI Health 29.02% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 35.84%
 
Chlamydia Screening in Women
The percentage of women 16–24 years of age who were identified as sexually active and who had at least one test for chlamydia.
Health PlanRateData Collection Method
PEHP 27.25% Administrative
EMI Health 25.71% Administrative
UnitedHealthCare 32.69% Administrative
Regence BlueCross BlueShield 30.92% Administrative
Aetna 32.79% Administrative
CIGNA 32.78% Administrative
Humana 20.66% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 30.81%
 
Prenatal and Postpartum care
The percentage of deliveries that had a postpartum visit on or between 21 and 56 days after delivery.
Health PlanRateData Collection Method
UnitedHealthCare 71.35% Admin+Chart Review
Regence BlueCross BlueShield 74.27% Admin+Chart Review
Aetna 45.51% Administrative
CIGNA 46.23% Admin+Chart Review
Humana 63.83% Admin+Chart Review
EMI Health 39.78% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 64.77%
 
Prenatal and Postpartum care
The percentage of deliveries that received a prenatal care visit as a member of the organization in the first trimester or within 42 days of eollment in the organization.
Health PlanRateData Collection Method
UnitedHealthCare 73.98% Admin+Chart Review
CIGNA 26.03% Admin+Chart Review
Humana 71.54% Admin+Chart Review
EMI Health 20.57% Administrative
Regence BlueCross BlueShield 78.64% Admin+Chart Review
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 70.13%
 
Non-Recommended Cervical Cancer Screening in Adolescent Females
The percentage of adolescent females 16–20 years of age who were screened unnecessarily for cervical cancer. Note: A lower rate indicates better performance.
Health PlanRateData Collection Method
UnitedHealthCare 3.47% Administrative
Aetna 2.91% Administrative
CIGNA 3.49% Administrative
Humana 1.11% Administrative
Regence BlueCross BlueShield 3.30% Administrative
NATIONAL AVERAGE: 0.00% STATE AVERAGE: 2.25%