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Health Care Initiatives | HIPAA | Health Care Quality Reports | Physician Advisory Board | ePrescribe
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:
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. 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:
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