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Highmark HEDIS 2020 Results for Measurement Year 2019

The Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used set of performance measures in the managed care industry.  Developed by the National Committee for Quality Assurance (NCQA®), HEDIS is part of a larger system which complements the NCQA accreditation program and establishes accountability in health care as performance measurements used by the Centers for Medicare and Medicaid Service (CMS) and other third party reporting agencies.  In areas of most concern to your patients, HEDIS helps compare how managed care plans perform.

HEDIS data is collected annually for members of Highmark’s various products. The HEDIS measures span several domains:  

  • Effectiveness of care
  • Access/availability of care
  • Experience of care
  • Utilization and Risk Adjusted Utilization
  • Health plan descriptive information

 The following subset of HEDIS measures provides a comparison based on services received in the measurement year (MY) 2019 for the HEDIS reporting year (RY) 2020 as compared to the 2020 Quality Compass® national averages.  For additional comparison, MY 2018 results are included.

Important Note:  The source of the National Average data contained in this publication is from Quality Compass® 2020 and is used with the permission of NCQA®.  Quality Compass® 2020 includes certain 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. 
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA). 
Quality Compass® is a registered trademark of the National Committee for Quality Assurance. 
NCQA® is a registered trademark of the National Committee for Quality Assurance.
CAHPS®, Consumer Assessment of Healthcare Providers and Systems, is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).
Additional information related to 2020 HEDIS/CAHPS reporting requirements and Covid-19 per NCQA®: https://www.ncqa.org/covid/
Per CMS guidance, Quality Compass® 2020 Medicare products will not be reported or released.
Last updated on 3/2/2021 12:14:25 PM

 

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The following entities, which serve the noted regions, are independent licensees of the Blue Cross Blue Shield Association: Western and Northeastern PA: Highmark Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Choice Company, Highmark Health Insurance Company, Highmark Coverage Advantage Inc., Highmark Benefits Group Inc., First Priority Health, First Priority Life or Highmark Senior Health Company. Central and Southeastern PA: Highmark Inc. d/b/a Highmark Blue Shield, Highmark Benefits Group Inc., Highmark Health Insurance Company, Highmark Choice Company or Highmark Senior Health Company. Delaware: Highmark BCBSD Inc. d/b/a Highmark Blue Cross Blue Shield. West Virginia: Highmark West Virginia Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Health Insurance Company or Highmark Senior Solutions Company. Western NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Cross Blue Shield. Northeastern NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Shield.

All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration and/or to one or more of its affiliated Blue companies.