• This is a Healthcare Effectiveness & Data Information Set (HEDIS®) administrative measure and only includes Medicaid Primary beneficiaries.
• The annual reported rate captures activity during the stated measurement year (MY).
• The target trendline in the graph above represents the 50th 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 female Medicaid beneficiaries are being screened for breast cancer. It assesses the percentage of women between 50 and 74 years of age who had a mammogram in the last 2 years.

Breast cancer is the 2nd most common type of cancer among American women. It is most common in women over 50. Women whose breast cancer is detected early have more treatment choices and better chances for survival. Mammography screening has been shown to reduce mortality by 20-30% among women 40 and older. A mammogram can reveal tumors too small to be felt by hand; it can also show other changes in the breast that may suggest cancer. However, messaging to the public regarding mammogram testing standards can be confusing.

Vermont Medicaid partnered with the Vermonters Taking Action Against Cancer (VTAAC) Cancer Prevention & Detection Workgroup, the Vermont Department of Health's Comprehensive Cancer Control (CCC) Program, Blue Cross Blue Shield of Vermont, and MVP on a quality improvement project from 2013-2017.  Additionally, as part of an Adult Medicaid Quality (AMQ) grant, DVHA developed and implemented a Breast Cancer Screening (BCS) Performance Improvement Project from 2013-2015.  Both projects' goal was to increase the overall rate of female Medicaid beneficiaries receiving a mammogram, in part through gap-in-care reporting to providers.  Project results were modest. 

The drop in our rate in 2021 (for measurement year 2020) is likely attributable to the COVID-19 pandemic.

Last updated:  September 2021

• Medicaid beneficiaries
• Selected Blueprint practices
• Vermonters Taking Action Against Cancer (VTAAC)
• Vermont Department of Health (VDH)
• Blue Cross Blue Shield of Vermont (BCBSVT)
• MVP

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“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. 

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