HEDIS® MY 2020

Measurement Year (MY) 2020 Data

Completing an NCQA HEDIS Compliance Audit™ has been required of managed care organizations (MCOs) operating in Maryland since 2001. Under the HealthChoice regulations, the MCOs report designated subsets of the Medicaid HEDIS measures. MedStar Family Choice benchmarks its performance against the Maryland Medicaid plans and the NCQA Means and Percentiles Report. NCQA accredits and certifies a wide range of healthcare organizations and manages the evolution of HEDIS.

The Maryland Department of Health and NCQA require plans to submit all measures required for Medicaid plans  to retain NCQA accreditation and other measures at it’s the department’s discretion.

We are happy to report MedStar Family Choice scored above or met the Maryland average for HEDIS 2020 on 2019 rates in the following areas:
  • Weight Assessment - BMI Percentile, Total (WCC)
  • Immunizations for Adolescents - Combo 1 (IMA)
  • Immunizations for Adolescents - Combo 2 (IMA)
  • Breast Cancer Screening (BCS)
  • Use of Spirometry Testing in the Assessment and Diagnosis of COPD (SPR)
  • Pharmacotherapy Management of COPD Exacerbation - Bronchodilator (PCE)
  • Statin Therapy for Patients with Cardiovascular Disease - Received Therapy - Total (SPC)
  • Statin Therapy for Patients with Cardiovascular Disease - Adherence - Total (SPC)
  • Comprehensive Diabetes Care - HbA1c Screening (CDC)
  • Comprehensive Diabetes Care - HbA1C (poor) Control (>9%) (CDC)
  • Comprehensive Diabetes Care - HbA1C Control (<8%) (CDC)
  • Comprehensive Diabetes Care - Eye Exams (CDC)
  • Comprehensive Diabetes Care - Blood Pressure Control (<140/90) (CDC)
  • Statin Therapy for Patients with Diabetes - Received Statin Therapy (SPD)
  • Statin Therapy for Patients with Diabetes - Statin Adherence - 80% (SPD)
  • Non-Recommended Cervical Cancer Screening in Adolescent Females (NCS)
  • Use of Opioids from Multiple Providers - Multiple Pharmacies (UOP)
  • Adults' Access to Preventive/Ambulatory Services - Ages 20-44 (AAP)
  • Adults' Access to Preventive/Ambulatory Services - Ages 45-64 (AAP)

MedStar Family Choice continues to score high compared to the Maryland Medicaid average for many measures. MedStar Family Choice would like to thank you for your cooperation and assistance in getting our members into care.

To further improve we will be coordinating with your offices by providing gaps in care reports and helping to identify members who need care. We have many resources to address transportation, scheduling, and other barriers for your members. We also offer mail-order pharmacy and 90-day prescriptions for most chronic medications. Please call us Monday through Friday 8:30 a.m. - 5 p.m. at 800-905-1722 for more information.

Proposed Focus for HEDIS MY 2020

Areas targeted for the next HEDIS cycles are those areas where MedStar Family Choice feels its performance can be improved or where improvement can be sustained and increased:
  • Wellness, Immunizations, and PCP Visits for Adults and Children
  • Prenatal and Postpartum Care
  • Diabetes Care (A1C Screening, A1C Control, and Dilated Eye Exam)
  • Mammograms, Pap Testing, and Chlamydia Testing
  • Medications for Asthma, Diabetes, and Cholesterol

As we continue to improve and strive for high scores, your dedication to quality health care is very much appreciated.

NCQA HEDIS Compliance Audit™ is a trademark of the National Committee for Quality Assurance (NCQA).
HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).

Information current as of: