Others titles
- HEDIS Part C Quality Measures CMS Star Ratings 2016
- HEDIS Part C Quality Measures CMS 2016
- Quality Metrics HEDIS Part C 2016
- Health Measures HEDIS Part C 2016
- Performance Measure HEDIS Part C Quality Measures 2016
Keywords
- CMS Star Rating
- CMS Measures
- CMS Quality Metrics
- CMS Health Measures
- CMS Performance Measures
- HEDIS Tool
- HEDIS Data
- NCQA Measurement Processmance Quality Measures Medicare Ratings 2016
HEDIS Part C Disease Screening Quality Measures 2014 to 2018
The dataset explains different metrics or standard of measurement for Part C (Medicare private health plans) reported at the contract level with less than 500 enrolled. Medicare Part C is the part of Medicare policy that allows private health insurance companies to provide Medicare benefits. These Medicare private health plans, such as HMOs (Health Maintenance Organization) and PPOs (Preferred Provider Organization), are known as Medicare Advantage Plans.
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Description
The Healthcare Effectiveness Data and Information Set (HEDIS) is one of the most widely used sets of health care SHOULD BE ONE WORD performance measure in the United States. The NCQA measurement development process has expanded the size and scope of HEDIS to include measures for physicians, Preferred Provider Organizations (PPO) and other Health Maintenance Organizations (HMO). The HEDIS is a tool used by more than 90 percent of America’s health plans to measure performance on important dimensions of care and service. NCQA collects HEDIS data directly from Health Plan Organizations and Preferred Provider Organizations for multiple purposes via the Healthcare Organization Questionnaire (HOQ) and HEDIS non-survey data through the Interactive Data Submission System (IDSS). National Committee for Quality Assurance (NCQA) collects Medicare HEDIS data on behalf of the Centers for Medicare & Medicaid Services (CMS), and Medicaid HEDIS data on behalf of state agencies. In addition, NCQA collects commercial data on behalf of some states and the U.S. Office of Personnel Management for health plan report cards.
The National Committee for Quality Assurance (NCQA) is an independent non-profit organization in the United States that works to improve health care quality through the administration of evidence-based standards, measures, programs, and accreditation. NCQA operates on a formula of measure, analyze, and improve and it aims to build consensus across the industry by working with policymakers, employers, doctors, and patients, as well as health plans. Health plans seek accreditation and measure performance through the administration and submission of the Healthcare Effectiveness Data and Information Set (HEDIS) and Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey.
HEDIS data collected by NCQA are important for researchers working to improve the health care system, as well as for NCQA staff seeking to improve the HEDIS measures themselves. Commercial HEDIS data are used to calculate national performance statistics and benchmarks, as well as to set standards for measures included in NCQA’s Accreditation program. Developing a measure is a multi-step process. It involves identifying the clinical area to evaluate; conducting an extensive literature review; developing the measure with the appropriate MAP and other panels; vetting it with various stakeholders; and performing a field-test that looks at feasibility, reliability and validity. NCQA consistently raises the bar. Accredited health plans today face a rigorous set of more than 60 standards and must report on their performance in more than 40 areas in order to earn NCQA’s seal of approval. These standards will promote the adoption of strategies that will improve care, enhance service and reduce costs, such as paying providers based on performance, leveraging the Web to give consumers more information, disease management and physician-level measurement. Many plans collect HEDIS data, and because the measures are so specifically defined, HEDIS makes it possible to compare the performance of health plans.
About this Dataset
Data Info
Date Created | 2015-12-17 |
---|---|
Last Modified | 2022-01-20 |
Version | 2022-01-01 |
Update Frequency |
Annual |
Temporal Coverage |
2014-01-01 to 2018-12-31 |
Spatial Coverage |
United States |
Source | John Snow Labs; Centers for Medicare & Medicaid Services; |
Source License URL | |
Source License Requirements |
N/A |
Source Citation |
N/A |
Keywords | CMS Star Rating, CMS Measures, CMS Quality Metrics, CMS Health Measures, CMS Performance Measures, HEDIS Tool, HEDIS Data, NCQA Measurement Processmance Quality Measures Medicare Ratings 2016 |
Other Titles | HEDIS Part C Quality Measures CMS Star Ratings 2016, HEDIS Part C Quality Measures CMS 2016, Quality Metrics HEDIS Part C 2016, Health Measures HEDIS Part C 2016, Performance Measure HEDIS Part C Quality Measures 2016 |
Data Fields
Name | Description | Type | Constraints |
---|---|---|---|
Year | Performance Year of Part C (2014, 2015 and 2016) | date | - |
Contract_Number | Contract number for measurement for Part C | string | - |
Organization_Marketing_Name | Organization Marketing Name | string | - |
Contract_Name | Contract Name (Insurance Company) | string | - |
Parent_Organization | Parent Organization of Insurance Company | string | - |
Breast_Cancer_Screening | Performance data for Breast Cancer Screening | string | - |
Colorectal_Cancer_Screening | Performance data for Colorectal Cancer Screening | string | - |
Cardiovascular_Care_Cholesterol_Screening | Performance data for Cardiovascular Care (Cholesterol Screening) | string | - |
Diabetes_Care_Cholesterol_Screening | Performance data for Diabetes Care (Cholesterol Screening) | string | - |
Glaucoma_Testing | Performance data for Glaucoma Testing | string | - |
Adult_BMI_Assessment | Performance data for Adult BMI Assessment | string | - |
Care_For_Older_Adults_Medication_Review | Care for Older Adults Medication Review | string | - |
Care_For_Older_Adults_Functional_Status_Assessment | Care for Older Adults (Functional Status Assessment) | string | - |
Care_For_Older_Adults_Pain_Assessment | Care for Older Adults (Pain Assessment) | string | - |
Osteoporosis_Management_In_Women_Who_Had_A_Fracture | Performance data for Osteoporosis Management in Women who had a Fracture | string | - |
Diabetes_Care_Eye_Exam | Performance data for Diabetes Care (Eye Exam) | string | - |
Diabetes_Care_Kidney_Disease_Monitoring | Performance data for Diabetes Care (Kidney Disease Monitoring) | string | - |
Diabetes_Care_Blood_Sugar_Controlled | Performance data for Diabetes Care (Blood Sugar Controlled) | string | - |
Diabetes_Care_Cholesterol_Controlled | Performance data for Diabetes Care (Cholesterol Controlled) | string | - |
Controlling_Blood_Pressure | Performance data for Controlling Blood Pressure | string | - |
Rheumatoid_Arthritis_Management | Performance data for Rheumatoid Arthritis Management | string | - |
Plan_All_Cause_Readmissions | Plan for all cause readmissions | string | - |
Data Preview
Year | Contract Number | Organization Marketing Name | Contract Name | Parent Organization | Breast Cancer Screening | Colorectal Cancer Screening | Cardiovascular Care Cholesterol Screening | Diabetes Care Cholesterol Screening | Glaucoma Testing | Adult BMI Assessment | Care For Older Adults Medication Review | Care For Older Adults Functional Status Assessment | Care For Older Adults Pain Assessment | Osteoporosis Management In Women Who Had A Fracture | Diabetes Care Eye Exam | Diabetes Care Kidney Disease Monitoring | Diabetes Care Blood Sugar Controlled | Diabetes Care Cholesterol Controlled | Controlling Blood Pressure | Rheumatoid Arthritis Management | Plan All Cause Readmissions |
2014 | H0141 | McLarenAdvantage | MCLAREN HEALTH PLAN, INC. | McLaren Health Care Corporation | 58.0 | 44.0 | 72.0 | 54.0 | 80.0 | 53.0 | 85.0 | 57.0 | 31.0 | 39.0 | 8.0 | ||||||
2014 | H0294 | Care Improvement Plus | CARE IMPROVEMENT PLUS WISCONSIN INSURANCE COMPANY | UnitedHealth Group, Inc. | 12.0 | ||||||||||||||||
2014 | H0408 | UnitedHealthcare | UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK | UnitedHealth Group, Inc. | |||||||||||||||||
2014 | H0490 | Molina Healthcare of Ohio | MOLINA HEALTHCARE OF OHIO, INC. | Molina Healthcare, Inc., | 36.0 | 85.0 | 77.0 | 42.0 | 92.0 | 77.0 | 56.0 | 58.0 | 10.0 | ||||||||
2014 | H0502 | Contra Costa Health Plan | THE CONTRA COSTA HEALTH PLAN | Contra Costa Health Services | 68.0 | 58.0 | 80.0 | 70.0 | 76.0 | Benefit not offered by plan | 67.0 | 63.0 | 71.0 | 49.0 | 60.0 | Benefit not offered by plan | |||||
2014 | H0657 | Colorado Choice Health Plans | COLORADO CHOICE HEALTH PLANS | Colorado Choice Health Plans | 31.0 | 34.0 | 47.0 | 59.0 | 55.0 | 45.0 | 62.0 | 51.0 | 27.0 | 47.0 | |||||||
2014 | H0901 | Aetna Medicare | AETNA HEALTH, INC. (PA) | Aetna Inc. | 59.0 | 76.0 | 66.0 | 47.0 | 70.0 | 90.0 | 70.0 | 34.0 | 44.0 | 5.0 | |||||||
2014 | H0908 | Advantage by Buckeye Community Health Plan | BUCKEYE COMMUNITY HEALTH PLAN, INC. | Centene Corporation | 55.0 | 37.0 | 77.0 | 44.0 | 61.0 | 48.0 | 88.0 | 35.0 | 21.0 | 55.0 | 11.0 | ||||||
2014 | H1200 | Kaiser Permanente Medicare Cost | KAISER FOUNDATION HP, INC. | Kaiser Foundation Health Plan, Inc. | 64.0 | 9.0 | |||||||||||||||
2014 | H1291 | Humana Insurance Company of New York | HUMANA INSURANCE COMPANY OF NEW YORK | Humana Inc. | 61.0 | 47.0 | 84.0 | 85.0 | 59.0 | 72.0 | 53.0 | 84.0 | 42.0 | 26.0 | 55.0 | 11.0 |