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Pharmacy - Quality Report Cards - HEDIS

Quality Report Cards give you information to help you evaluate Aetna Health plans. The report cards use a set of measures called the Healthcare Effectiveness Data and Information Set (HEDIS^®).

HEDIS measures were developed by the National Committee for Quality Assurance (NCQA). This is an independent, nonprofit organization whose mission is to improve health care quality. HEDIS performance measures tell how well health plans perform in these important areas:

• quality of care
• access to care
• member satisfaction with the health plan and doctors

The information health plans collect for HEDIS must be in a standard format, which helps to ensure comparisons between plans are fair and valid. You can use HEDIS results, listed in the report cards, to evaluate the quality of different health plans and make decisions about health benefits based on demonstrated value, not just on cost. To find more information about report cards, visit the NCQA website at (http://web.ncqa.org/).

Aetna is a leader in promoting the measurement of quality and quality improvement in health care. We are proud to be among the first health plans to publish HEDIS data.

Aetna offers HEDIS Quality Report Cards by state, in a reader-friendly format. Please select below for available state report cards. Not all states offer report cards.

Arizona 2007 California 2007 Colorado 2007 Connecticut 2007 Delaware 2007 Florida 2007 Georgia 2007 Illinois 2007 Indiana 2007 Kansas 2007 Maine 2007 Maryland 2007 Massachusetts 2007 Missouri 2007 Nevada 2007 New Jersey - North 2007 New Jersey - South 2007 New York 2007 North Carolina 2007 Ohio 2007 Oklahoma 2007 Pennsylvania 2007 South Carolina 2007 Tennessee 2007 Texas 2007 Virginia 2007 Washington, DC 2007

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Report Card Components

Each HEDIS Quality Report Card includes information on access to care, preventive care and health screenings, maternity care, treatment of acute and chronic illness, mental health care and member satisfaction.

Access to Care

Report cards show how well the health plan provided its members with access to needed care. Members should have access to their doctors for routine and preventive care. The report cards list the percentage of adults and children who visited their doctor for routine or preventive care.

Prevention and Screening

Report cards show the percentage of members who received proper health screenings. Health plans should promote early detection of diseases by raising member awareness and encouraging screenings. Health plans should also encourage members to receive appropriate vaccinations, a proven defense against many illnesses.

Maternity Care

Report cards show the percentage of pregnant women who received proper maternity care. Health plans should encourage appropriate prenatal and postpartum care.

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Treatment of Acute and Chronic Illness

Report cards show the percentage of members who received proper treatment for acute and chronic conditions. Health plans should measure how well doctors treat acute and chronic illnesses. Areas that health plans review include:

• Treatment for cardiovascular conditions including high cholesterol and high blood pressure
• Comprehensive treatment for diabetes
• Use of appropriate medications for asthma

Mental Health

Report cards show the percentage of members who received treatment for mental illness and appropriate follow-up care.

Member Satisfaction

Report cards also show data on member satisfaction with the health plan and the doctors in its network. This information indicates how well the health plan meets members' expectations.

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