2013 Health Plan Quality of Care Report for Utah Commercial HMOs, Medicaid & CHIP Health Plans (HEDIS)
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KEY FINDINGS

To determine how health plans in Utah are performing compared to other health plans in the nation, State averages are compared with National averages. Commercial Preferred Provider Organizations (PPOs) reported HEDIS data to the state for the first year in 2013.

  • Commercial PPOs are equal to or exceeding national averages on well care for adults, care for people with diabetes and avoidance of unnecessary treatment/testing. Commercial PPOs are under-performing on prenatal and post-partum care, childhood immunizations, well care for children and diabetes care.
  • Commercial HMOs on avoiding inappropriate treatment, immunizations for children and adolescents, and preventive services for adults. The Commercial HMOs are not doing well on Chlamydia screenings, well-child visits for 3-6 year olds, and some measures of diabetes care.
  • CHIP plans performed well on use of medications, immunizations, and access to primary care providers. They are doing less well on lead screening for children, well-care visits for adolescents and children.
  • Medicaid HMOs performed above national averages on childhood and adolescent immunizations, diabetes care, and avoidance of inappropriate treatments. Medicaid plans are well below national averages on prenatal and post-partum care, chlamydia screenings and well child visits for children.