• This is a Healthcare Effectiveness & Data Information Set (HEDIS®) administrative measure and only include Medicaid Primary beneficiaries.
• The annual reported rate captures activity during the stated measurement year (MY).
• The target trendline in the graph above represents the 75th national benchmark percentile for Medicaid programs across the country.

The Healthcare Effectiveness Data and Information Set (HEDIS®) is a registered trademark of NCQA.

This measure looks at whether adult members receive preventive and ambulatory services. It looks at the percentage of Vermont adults with Medicaid who have had a preventative or ambulatory visit to their physician. Consider the other side of this measure: How many patients never access the system? If they never access the healthcare system, how does preventive care and counseling (diet, exercise, smoking cessation, seat belt use, etc.) occur? This measure is an indicator as to whether there may be barriers to our beneficiaries accessing preventive care. The drop in our rate in 2021 (for measurement year 2020) is likely attributable to the COVID-19 pandemic.

Last updated: September 2021

Although DVHA performs well on this measure, we noticed in 2017 that our rates were below the 50th percentile national benchmark for 3 consecutive years. The DVHA Quality Committee recommended that we convene a Quality Improvement work group to explore this measure further. The project team included DVHA Quality Unit, Clinical, Data, VCCI and Provider & Member Relations staff. The team circulated a banner release and a Medicaid provider newsletter article related to medical record transfers (an activity that can increase the wait time for appointment scheduling). 

NCQA’s Notice of Copyright and Disclaimers 
“The source for certain health plan measure rates and benchmark (averages and percentiles) data (“the Data”) is Quality Compass® 2022 and is used with the permission of the National Committee for Quality Assurance (“NCQA”). Any analysis, interpretation or conclusion based on the Data is solely that of the authors, and NCQA specifically disclaims responsibility for any such analysis, interpretation or conclusion. Quality Compass is a registered trademark of NCQA. 

The Data comprises audited performance rates and associated benchmarks for Healthcare Effectiveness Data and Information Set measures (“HEDIS® ”) and HEDIS CAHPS® survey measure results. HEDIS measures and specifications were developed by and are owned by NCQA. HEDIS measures and specifications are not clinical guidelines and do not establish standards of medical care. NCQA makes no representations, warranties or endorsement about the quality of any organization or clinician that uses or reports performance measures or any data or rates calculated using HEDIS measures and specifications, and NCQA has no liability to anyone who relies on such measures or specifications. 

NCQA holds a copyright in Quality Compass and the Data and can rescind or alter the Data at any time. The Data may not be modified by anyone other than NCQA. Anyone desiring to use or reproduce the Data without modification for an internal, noncommercial purpose may do so without obtaining approval from NCQA. All other uses, including a commercial use and/or external reproduction, distribution or publication, must be approved by NCQA and are subject to a license at the discretion of NCQA. © 2022 National Committee for Quality Assurance, all rights reserved. 

CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).”