Healthcare Effectiveness Data and Information Set (HEDIS®)
Each year, Braven Health takes part in a HEDIS program review. HEDIS is a tool that health plans throughout the country use to measure how well they provide service and care to their members. To find out how we rank, visit the NCQA Health Plan Rating. You can also visit NCQA.org for more information and a summary of HEDIS results by health plan.
2023 HEDIS® Results – Braven HMO
| HEDIS Accreditation Measure for Medicare | Description | Final HEDIS 2023 Performance Rate | HEDIS 2023 National Benchmark |
|---|---|---|---|
| Breast Cancer Screening | The percentage of women 50 to 74 years of age who had a mammogram to screen for breast cancer. | NA (Need 2 years prior to measurement year)* | 69.65% |
| Colorectal Cancer Screening | The percentage of members 50 to 75 years of age who had appropriate screening for colorectal cancer. | 63.65% | 67.62% |
| Eye Exam for Patients with Diabetes (EED) Diabetes | The percentage of members 18 to 75 years of age who had an eye screening for diabetic retinal disease and includes one of the following: a retinal or dilated eye exam by an eye care professional (optometrist or ophthalmologist) in the measurement year or a negative retinal or dilated eye exam (negative for retinopathy) by an eye care professional in the year prior to the measurement year. | 52.20% | 71.08% |
| Hemoglobin A1c Control for Patients With Diabetes - Poor HbA1c Control (greater than 9%) | The percentage of members 18 to 75 years of age whose last HbA1c test had a result of greater than 9.0% during the measurement year. | 15.61% | 22.84% |
| Hemoglobin A1c Control for Patients With Diabetes - HbA1c Control (less than 8%) | The percentage of members 18 to 75 years of age with diabetes types (1 and 2) whose hemoglobin A1c (HbA1C) was at less than 8.0% during the measurement year. | 70.24% | 67.83% |
| Comprehensive Diabetes Care Medical Attention for Nephropathy | The percentage of members 18 to 75 years of age who had a screening or monitoring test during the measurement year. | Retired | Retired |
| Controlling High Blood Pressure (Total Rate) | The percentage of members 18 to 85 years of age who had a diagnosis of hypertension (HTN) and whose blood pressure (BP) was adequately controlled during the measurement year. | 70.76% | 72.27% |
| Flu Shots for Older Adults | The percentage of members 65 years of age and older who received an influenza vaccination between July 1 of the measurement year and the date when the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey was completed. | 66.60% | 74.2% |
| Follow-Up After Hospitalization for Mental Illness (Seven-Day Rate) | The percentage of discharges for members six years of age and older (hospitalized for specified mental illnesses) who had a follow-up visit with a mental health provider within seven days of discharge. | NA denominator less than 30** | ND**** |
| Medical Assistance With Smoking Cessation (Advising Smokers to Quit) | The percentage of members 18 years of age and older who currently smoke and responded via survey that they received advice from a doctor about quitting during the measurement year. | NR*** | ND**** |
| Persistence of Beta-Blocker Treatment After a Heart Attack | The percentage of members 18 years of age and older during the measurement year who were hospitalized and discharged from July 1 of the year prior to the measurement year to June 30 of the measurement year with a diagnosis of acute myocardial infarction (AMI)/heart attack and who received persistent beta-blocker treatment for six months after discharge. | NA denominator less than 30** | 89.07% |
*NA (Need 2 years prior to measurement year)
**Not applicable, denominator less than 30
***No response
****Not determined
HEDIS® is a registered trademark of the National Committee for Quality Assurance.
An Independent Licensee of the Blue Cross Blue Shield Association.
2023 HEDIS® Results – Braven PPO
| HEDIS Accreditation Measure for Medicare | Description | Final HEDIS 2023 Performance Rate | HEDIS 2023 National Benchmark |
|---|---|---|---|
| Breast Cancer Screening | The percentage of women 50 to 74 years of age who had a mammogram to screen for breast cancer. | NA (Need 2 years prior to measurement year)* | 69.65% |
| Colorectal Cancer Screening | The percentage of members 50 to 75 years of age who had appropriate screening for colorectal cancer. | 63.65% | 67.62% |
| Eye Exam for Patients with Diabetes (EED) Diabetes | The percentage of members 18 to 75 years of age who had an eye screening for diabetic retinal disease and includes one of the following: a retinal or dilated eye exam by an eye care professional (optometrist or ophthalmologist) in the measurement year or a negative retinal or dilated eye exam (negative for retinopathy) by an eye care professional in the year prior to the measurement year. | 52.20% | 71.08% |
| Hemoglobin A1c Control for Patients With Diabetes - Poor HbA1c Control (greater than 9%) | The percentage of members 18 to 75 years of age whose last HbA1c test had a result of greater than 9.0% during the measurement year. | 15.61% | 22.84% |
| Hemoglobin A1c Control for Patients With Diabetes- HbA1c Control (less than 8%) | The percentage of members 18 to 75 years of age with diabetes types (1 and 2) whose hemoglobin A1c (HbA1C) was at less than 8.0% during the measurement year. | 70.24% | 67.83% |
| Comprehensive Diabetes Care Medical Attention for Nephropathy | The percentage of members 18 to 75 years of age who had a screening or monitoring test during the measurement year. | Retired | Retired |
| Controlling High Blood Pressure (Total Rate) | The percentage of members 18 to 85 years of age who had a diagnosis of hypertension (HTN) and whose blood pressure (BP) was adequately controlled during the measurement year. | 70.76% | 72.27% |
| Flu Shots for Older Adults | The percentage of members 65 years of age and older who received an influenza vaccination between July 1 of the measurement year and the date when the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey was completed. | 66.60% | 74.2% |
| Follow-Up After Hospitalization for Mental Illness (Seven-Day Rate) | The percentage of discharges for members six years of age and older (hospitalized for specified mental illnesses) who had a follow-up visit with a mental health provider within seven days of discharge. | NA denominator less than 30** | ND**** |
| Medical Assistance With Smoking Cessation (Advising Smokers to Quit) | The percentage of members 18 years of age and older who currently smoke and responded via survey that they received advice from a doctor about quitting during the measurement year. | NR*** | ND**** |
| Persistence of Beta-Blocker Treatment After a Heart Attack | The percentage of members 18 years of age and older during the measurement year who were hospitalized and discharged from July 1 of the year prior to the measurement year to June 30 of the measurement year with a diagnosis of acute myocardial infarction (AMI)/heart attack and who received persistent beta-blocker treatment for six months after discharge. | NA denominator less than 30** | 89.07% |
*NA (Need 2 years prior to measurement year)
**Not applicable, denominator less than 30
***No response
****Not determined
HEDIS® is a registered trademark of the National Committee for Quality Assurance.
An Independent Licensee of the Blue Cross Blue Shield Association.