Quality care can lower health care costs

Here are some of the measures used to determine a physician's quality of care. All measurements pertain to members enrolled in Priority Health group HMO and POS plans through their employers.

Preventive care quality measures

Routine screenings find cancer early and save lives. Immunizations protect children from preventable childhood diseases.

Breast cancer screening

Members who get routine mammograms every two years  2012  2013  2014  2015
Priority Health group health plans  79%   78%   84%  81%
National average for group health plans  70%   70%   74%  74%

Cervical cancer screening

Members who get routine Pap tests and/or HPV screening every three years  2012  2013  2014  2015
Priority Health group health plans  85%  84%  87%  84%
National average for group health plans  76%  76% Not reported  77%

Colorectal cancer screening

Members who get routine screenings  2012  2013  2014  2015
Priority Health group health plans  69%  75%  71%  72%
National average for group health plans  61%  63%  63%  63%

Childhood immunizations

 Members who get routine immunizations*  2012  2013  2014  2015 
Priority Health group health plans   85%  85%  87%  89%
National average for group health plans  76%  77%  76%  78%

*Diptheria/pertussis/tetanus, haemophilus influenza type B, hepatitus B, measles/mumps/rubella, pneumonia, polio, varicella

Control of chronic conditions

Asthma control

Good asthma treatment reduces emergency room visits.

Members who get the appropriate medication to keep their asthma under control  2012  2013  2014  2015
Priority Health group health plans  93%  93%  93%  91%
National average for group health plans  92%  91%  91%  91%

Diabetes - Cholesterol (LDL) control

Low LDL levels cut the risk of heart attack or premature death in half.

Members with diabetes who have their cholesterol under control    2012  2013  2014  2015
Priority Health group health plans   52%  58%  56%  Not reported
National average for group health plans  47%  48%  46%  Not reported

High blood pressure control

Good control of high blood pressure decreases the risk of heart attack and kidney disease.

Members with high blood pressure under control    2012  2013  2014  2015
Priority Health group health plans   72%  72%  70%  67%
National average for group health plans  65%  62%  63%  64%

Data sources

Priority Health's data is from Healthcare Effectiveness Data and Information Set (HEDIS®). HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).

The source for national average data is Quality Compass® 2015 and is used with the permission of the NCQA. Quality Compass 2015 includes certain Consumer Assessment of Healthcare Providers and Systems (CAHPS®) data. Any data display, analysis, interpretation, or conclusion based on these data is solely that of the authors, and NCQA specifically disclaims responsibility for any such display, analysis, interpretation, or conclusion. Quality Compass is a registered trademark of NCQA. CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).

Last modified: 7/8/2016
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