Our priorities include:
Also, as part of this program, each year we look at the Healthcare Effectiveness Data and Information Set (HEDIS®) measures. These measures focus on issues related to how well practitioners are ordering the right tests or immunizations and treating acute and chronic diseases as well as how well members are getting necessary exams. We trend the results, look for differences and then determine if interventions are needed. These measures also allow us to better understand how we are doing compared to other local health care organizations.
During the past year, we have focused on assisting members with medication adherence (filling prescriptions and staying on medications), watching to make sure the right lab tests are ordered when taking certain medications and providing members with health coaching. We will continue to focus on these topics next year as well as researching and creating new health programs.
In addition to these initiatives we have ongoing programs which include asthma, diabetes, hypertension, anxiety, depression and Attention-Deficit/Hyperactivity Disorder health management programs; prevention and wellness reminders; wellness rewards/reimbursements; weight management and behavioral health programs. You can find more information about our initiatives in our Health & Wellness section.
HEDIS is a set of health care performance measures that covers eight areas of care such as prevention and screening. Some measures use data collected from Unity claims while other measures’ data is collected through claims plus medical chart review. HEDIS may also be supplemented with other data sources such as the Wisconsin Immunization Registry (WIR).
Our annual HEDIS 2011 results, measured in 2010, show 18 measures met the 90th percentile meaning Unity performed better than 90% of other HMOs in the country. The 75th percentile was met in 40 measures.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
