Medicaid and CHIP Risk-Based Managed Care in 20 States. Experiences Over the Past Decade and Lessons for the Future.. Appendix C: HEDIS and CAhps Data

07/01/2012

Figure 1: Percent with Timely Prenatal Care

Figure 1: Percent with Timely Prenatal Care

Source: Aggregate state data.

Note: All states use the HEDIS definition: percent of deliveries that received a prenatal care visit as a member of the organization in the first trimester of with in 42 days of enrollment in the organization.

 

Figure 2: Percent with Well Child Visit

Figure 2: Percent with Well Child Visit

Source: Aggregate state data

Note: States use the HEDIS definition: percent of members 3-6 years of age who received one or more well-child visits with a primary care provider during the measurement year. Data are for Medicaid and CHIP unless otherwise specified.

 

Figure 2: Percent with Well Child Visit
State 2001-2005 Year Reporting 2006-2010 Year Reporting  

Source: Aggregate state data

Note: States use the HEDIS definition: percent of members 3-6 years of age who received one or more well-child visits with a primary care provider during the measurement year. Data are for Medicaid and CHIP unless otherwise specified.

Not reported: MD, PA, VA, WI

WA 51% 2003 59.90% 2009 *
VA     71.17% 2010  
TX CHIP     65.52% 2009  
TX Medicaid 55.87% 2003 71.38% 2009 This measure relies on specific provider specialty codes, and the state believes that it is likely inflated from the lifting of provider constraints.
TN     70.23% 2010 *
RI     76.50% 2009 *
PA CHIP 59.00% 2001 79.31% 2010  
PA Medicaid 57.80% 2001 75.35% 2010  
OH 50.10% 2001 52.20% 2010 U
NY CHIP 69.20% 2001 81% 2009  
NY Medicaid 81.00% 2001 79% 2009 *
NM     60.85% 2010 *
NJ     80.33% 2010 *
MN 52.63% 2003 67.83% 2010 *
MI 44.90% 2001 75.90% 2010 ?
MD 56.00% 2001 81.80% 2010  
MA 75.30%   85.50% 2010 *
FL CHIP     59.73% 2009  
FL Medicaid 44.92% 2001 69.64% 2009 *
DE     75.52% 2009 U
CT     82% 2010 *
CA CHIP 61.70% 2001 74.00% 2010  
CA Medicaid 54.20% 2001 76.10% 2010 *
AZ CHIP 56.8% 2003 73.70% 2010  
AZ Medicaid 44.40%   69.40% 2010 *

 

Figure 3: Percent of Children with Up-to-Date Immunizations

Figure 3: Percent of Children with Up-to-Date Immunizations

Source: Aggregate state data.

Note: States use the HEDIS definition: percent of children two years of age who had four DTaP/DT, three IPV, one MMR, three H infuenza typeB, three hepatitis B, and one chicken pox vaccine (VZV) by their second birthday. Data are for Medicaid and CHIP unless otherwise specified.

 

Figure 3: Percent of Children with Up-to-Date Immunizations
State 2001-2005 Year Reporting 2006-2010 Year Reporting HEDIS

Source: Aggregate state data.

Note: States use the HEDIS definition: percent of children two years of age who had four DTaP/DT, three IPV, one MMR, three H infuenza typeB, three hepatitis B, and one chicken pox vaccine (VZV) by their second birthday. Data are for Medicaid and CHIP unless otherwise specified.

Not reported: AZ, CT, FL, NY, OH, PA, TX

AZ Medicaid     79.30% 2009 *
AZ CHIP     88.20% 2010 *
CA Medicaid 50.50% 2001 80.10% 2010 U
CA CHIP 61.70% 2001 79.30% 2010 *
DE     78.00% 2009 *
MA 66.80% 2002 82.70% 2010  
MD 53% 2002 80.20% 2009  
MI 45.60% 2001 79% 2009  
MN 59.93% 2003 79.97% 2010 *
NJ     73.81% 2009 *
NM     77.46% 2010 *
NY Medicaid 63.90% 2001 79% 2010 U
NY CHIP 65% 2001 72% 2010 *
PA Medicaid 49.10% 2001 75.50% 2010 *
RI     80.70% 2009 U
TN 73.00% 2005 78.17% 2009  
VA     72% 2008 *
WA 46.43% 2001 76.72% 2010  
WI     72.20% 2010 *

 

Figure 4: Percent with Breast Cancer Screening

Figure 4: Percent with Breast Cancer Screening

Source: Aggregate state data.

Notes: Unless noted, states use the HEDIS definition: percent of women aged 40 through 69 years of age who had a mammogram in the prior two years.

1Percent of women aged 52-69 who had a mammogram in the prior two years.
2Percent of women aged 40-64 who had a mammogram in the prior two years.

 

Figure 4: Percent with Breast Cancer Screening
State 2001-2005 Year Reporting 2006-2010 Year Reporting HEDIS

Source: Aggregate state data.

Notes: Unless noted, states use the HEDIS definition: percent of women aged 40 through 69 years of age who had a mammogram in the prior two years.

1Percent of women aged 52-69 who had a mammogram in the prior two years.
2Percent of women aged 40-64 who had a mammogram in the prior two years.
Not reported: OH

AZ 55.00% 2001 65.70% 2010 Percentage of women aged 52-69 years of age who had a mammogram in the prior two years
CA 53.10% 2004     *
CT     60.70% 2010 *
DE     54.40% 2009 U
FL 54.48% 2001 50.01% 2009 *
MA 65% 2003 64.90% 2009 * (percentage of women aged 52 through 69 years of age who had a mammogram in the prior two years in 2003)
MD 51% 2001 49.50% 2010 % of women aged 40- 69 who had a mammogram
MI 53.80% 2001 55.10% 2010 U
MN 80.28% 2003 61.15% 2010 *
NM     48.14% 2010 *
NJ     53.43% 2010 *
NY 66% 2002 68% 2009 *
PA 55.60% 2001 56.11% 2010 % of women aged 40- 64 who had a mammogram to screen for breast cancer
RI     57.50% 2009 *
TN 40.70%   38.45%   *
TX 19.22% 2003 54.12% 2009 *
VA     46% 2010 U
WI     52.20% 2009 *
WA 76.90% 2001     U

 

Figure 5: Percent with Cervical Cancer Screening

Figure 5: Percent with Cervical Cancer Screening

Source: Aggregate state data.

Notes: Unless noted, states use the HEDIS definition: percent of women aged 21-64 who received one or more PAP tests to screen for cervical cancer in prior three years.

1Percentage of women aged 21-64 who received one or more Pap tests within the prior three years.

 

Figure 5: Percent with Cervical Cancer Screening
State 2001-2005 Year Reporting 2006-2010 Year Reporting HEDIS

Source: Aggregate state data.

Notes: Unless noted, states use the HEDIS definition: percent of women aged 21-64 who received one or more PAP tests to screen for cervical cancer in prior three years.

1Percentage of women aged 21-64 who received one or more Pap tests within the prior three years.
Not reported: OH, VA

AZ 51.00%   70% 2009 *
CA   2001     U
CT   2003 57.55% 2009 *
DE   2005 61.30% 2010 *
FL 50.92%   76.20% 2009 *
MA 79% 2001 66.24% 2010 *
MD 44% 2001 73.40% 2008 *
MI 53.20%   63.92% 2010 *
MN 70.63%   64.29% 2010 *
NJ   2003 75.27% 2010 *
NM   2001 72.70% 2010 U
NY 74.50% 2001 68.10% 2010 *
PA 54.40% 2003 77.40% 2009 *
RI   2001 55.00% 2009 *
TN 54.10%   64.41% 2008 U
TX 25.97%   71.80% 2010 *
WA 66.20%   69.50% 2010 Percentage of women 21-64 years of age who received one or more Pap tests within the prior three years
WI   2001 62.60% 2010 *

 

Figure 6: Percent of Diabetics with HbA1c Test

Figure 6: Percent of Diabetics with HbA1c Test

Source: Aggregate state data.

Notes: Unless noted, states use the HEDIS definition: percent of members aged 18-75 with diabetes who had one or more HbA1c test(s) during the measurement year.

 

Figure 6: Percent of Diabetics with HbA1c Test
State 2001-2005 Year Reporting 2006-2010 Year Reporting HEDIS

Source: Aggregate state data.

Notes: Unless noted, states use the HEDIS definition: percent of members aged 18-75 with diabetes who had one or more HbA1c test(s) during the measurement year.

CA     82.80% 2010 *
CT     76.10% 2010 *
DE     74.25% 2009 U
MA 81.60% 2002 90.70% 2009 *
MD 71% 2002 77.10% 2010 *
MI 59.50% 2001 83.90% 2010 U
MN 87.98% 2003 90.29% 2010 *
NJ     79.23% 2010 *
NM     84.53% 2010 *
NY 79.90% 2002 89% 2009 *
OH 55.70% 2002 66.50% 2010 U
PA 61.90% 2001 82.74% 2010 The percentage of members 19-64 years of age with diabetes (type 1 and type 2) who had HbA1c testing
RI     85.40% 2009 *
TN 67.40% 2005 77.93% 2010 *
TX     70.83% 2009 *
VA     81% 2010 U
WA 75.10% 2001 83.67% 2010 *
WI     78.30% 2009 *

 

Figure 7: Perents’ Overall satisfaction with Health Plan for Children

Figure 7: Perents’ Overall satisfaction with Health Plan for Children

 

Figure 7: Perents’ Overall satisfaction with Health Plan for Children
State 2001-2005 Year reporting 2006-2010 Year Reporting Percent Reported Population

Source: Aggregate state data.

Note: CAHPS question is: "On a scale from 0 to 10, with 10 being the highest, over, how satisfied are you with your health plan?"

CT     74.40% 2010 % reporting 8-10 Adult
DE     77.30% 2010 % reporting 8-10 Adult and Children
MD     76% 2010 % reporting 8-10 Adult
MI 72% 2003 77% 2010 % reporting 8-10 Adult
NM     76.84% 2010 % reporting 8-10 Adult
NY 72.20% 2001 67% 2009 % reporting 8-10 Adults and Children
PA     77.18% 2010 % reporting 8-10 in 2010 Adult
VA     78% 2010 % reporting 8-10  
MA 56% 2002 57% 2006 % reporting 9 or 10 Adults
MN     59% 2009 % reporting 9 or 10 Adults and Children
NJ     58% 2009 % reporting 9 or 10 Adults
OH     59.7% 2009 % reporting 9 or 10 Adult
RI     55.84% 2010 % reporting 9 or 10 Adult
TN     65.04% 2010 % reporting 9 or 10 Adult
WA     52% 2007 % reporting 9-10 in 2007 Adults

 

Figure 8: Parents’ Overall Satisfaction with Heath Care for Children

Figure 8: Parents’ Overall Satisfaction with Heath Care for Children

Source: Aggregate state data.

Note: CAHPS question is: "On a scale from 0 to 10, with 10 being the highest, overall, how satisfied are you with your health care?"

 

Figure 8: Parents' Overall Satisfaction with Health Care for Children
State 2001-2005 Year Reporting 2006-2010 Year Reporting Percent Reported Population

Source: Aggregate state data.

Note: CAHPS question is: "On a scale from 0 to 10, with 10 being the highest, overall, how satisfied are you with your health care?"

CA 80.26% 2003 83.10%   % reporting 8-10 CHIP
CT     85.90% 2010 % reporting 8-10 Medicaid and CHIP
DE     86.50% 2010 8to10 Medicaid and CHIP
FL 87.80% 2005 85.10% 2010 % reporting 8-10 CHIP
MD     82% 2010 % reporting 8-10 Medicaid and CHIP
MI     82.40% 2009 % reporting 8-10  
NM     78.70% 2010 % reporting 8-10. Medicaid and CHIP
PA     80.91% 2010 % reporting 8-10 Medicaid
TX     84.62% 2010 % reporting 8-10 CHIP
VA     83.00% 2010 % reporting 8-10  
WA 66% 2001 79.60% 2010 % reporting 8-10 CHIP
WA 73% 2001     % reporting 8-10 Medicaid
MA 67% 2002 71% 2006 % reporting 9-10 Medicaid and CHIP
NJ     66% 2009 % Reporting 9-10 Medicaid
OH     59.90% 2009 % Reporting 9-10 Medicaid
TN     63.30% 2010 % reporting 9-10 Medicaid

 

Figure 9: Parents’ Overall Satisfaction with Personal Doctor for Children

Parents’ Overall Satisfaction with Personal Doctor for Children

Source: Aggregate state data.

Note: CAHPS question is: "On a scale from 0 to 10, with 10 being the highest, overall, how satisfied are you with your personal doctor?"

 

Figure 9: Parents’ Overall Satisfaction with Personal Doctor for Children
Statistic Timeliness of Prenatal Care 2001-2005 (M=12) Timeliness of Prenatal Care 2006-2010 (M=18) Well Child Visits 2001-2005 (M=11, C=4) Well Child Visits 2006-2010(M=19, C=6) Childhood Immunization 2001-2005 (M=9, C=2) Childhood Immunization 2006-2010 (M=16, C=3)

Source: Aggregate state data.

Note: CAHPS question is: "On a scale from 0 to 10, with 10 being the highest, overall, how satisfied are you with your personal doctor?"

Q1 0.72 0.81 0.51 0.67 0.50 0.76
Min 0.56 0.68 0.45 0.52 0.46 0.72
Median 0.74 0.84 0.56 0.73 0.60 0.79
Max 0.82 0.91 0.81 0.86 0.73 0.88
Q3 0.80 0.88 0.64 0.79 0.65 0.80
N 16.00 12.00 14.00 13.00 4.00 13.00

 

Figure 10: Parents’ Overall Satisfaction with Specialist Care for Children

Figure 10: Parents’ Overall Satisfaction with Specialist Care for Children

Source: Aggregate state data.

Note: CAHPS question is: "On a scale from 0 to 10, with 10 being the highest, overall, how satisfied are you with your specialist care?"

 

Figure 10: Parents’ Overall Satisfaction with Specialist Care for Children
Statistic HbA1c 2001-2005 (N=9) HbA1c 2006-2010 (N=18) Cervical Cancer Screening 2001-2005 (N=12) Cervical Cancer Screening 2006-2010 (N=16) Breast Cancer Screening 2001-2005 (N=12) Breast Cancer Screening 2006-2010 (N=18)

Source: Aggregate state data.

Note: CAHPS question is: "On a scale from 0 to 10, with 10 being the highest, overall, how satisfied are you with your specialist care?"

Q1 0.61 0.77 0.51 0.64 0.53 0.51
Min 0.56 0.67 0.26 0.55 0.19 0.38
Median 0.69 0.82 0.54 0.67 0.55 0.54
Max 0.88 0.91 0.79 0.77 0.80 0.68
Q3 0.76 0.84 0.69 0.73 0.65 0.60
N 16.00 12.00 14.00 13.00 4.00 13.00

 

Figure 11: Overall Satisfaction with Health Plan for Adults

Figure 11: Overall Satisfaction with Health Plan for Adults

Source: Aggregate state data.

Note: CAHPS question is: "On a scale from 0 to 10, with 10 being the highest, overall, how satisfied are you with your health plan?"

1Population includes children.

 

 

Figure 11: Overall Satisfaction with Health Plan for Adults
State 2001-2005 Reporting Year 2006-2010 Reporting Year Reported Population

Source: Aggregate state data.

Note: CAHPS question is: "On a scale from 0 to 10, with 10 being highest, overall, how satisfied are you with your health plan?"

1Population includes children.
Medicaid 2010 National Average for Rating 8-10 = 72.40%; Rating 9-10 = 54.7%
Commercial 2010 National Average for Rating 8-10 = 64.2%; Rating 9-10=40.3%

CT     72.70% 2010 % reporting 8-10 Adults
DE1     77.35% 2010 % reporting 8 to 10 Adults and Children
MD     67.00% 2010 % reporting 8,9, 10 Adults
MI 61% 2003 69.40% 2010 % reporting 8 to 10 Adults
NM     79.77% 2010 % reporting 8 to 10 Adults
NY1 69.90% 2001 69.00% 2009 % reporting 8,9, or 10 Adults and Children
PA     76.17% 2010 in 2010, measure is % reporting 8-10 Adults
VA     75.00% 2010 % reporting 8 to 10 Adults
WI1 83.20% 2002 82.40% 2008 % reporting 8 to 10 Adults and Children
MA 56.00% 2002 53.00% 2006 % reporting 9 or 10 Adults
MN1     55.00% 2009 % reporting 9 or 10 Adults and Children
OH     44.60% 2008 % reporting 9 or 10 Adults
RI     59.60% 2010 % reporting 9 or 10 Adults
TN     53.76% 2010 % reporting 9 or 10 Adults
WA     46.00% 2007 % reporting 10 in 2001, % reporting 9-10 in 2007 Adults
FL 40.73% 2003 37.51% 2010 % reporting 10 Adults

 

Figure 12: Overall Satisfaction with Health Care for Adults

Source: Aggregate state data.

Note: CAHPS question is: "On a scale from 0 to 10, with 10 being the highest, overall, how satisfied are you with your health care?"

1Population includes children.

 

Figure 12: Overall Satisfaction with Health Care for Adults
State 2001-2005 Year Reported 2006-2010 Year Reported Percent Reporting Population

Source: Aggregate state data.

Note: CAHPS question is: "On a scale from 0 to 10, with 10 being the highest, overall,how satisfied are you with your health care?"

1Population includes children.
Medicaid 2010 National Average for Rating 8-10 = 68.9%; Rating 9-10 = 48.8%
Commercial 2010 National Average for Rating 8-10 = 76.6%; Rating 9-10=50.7%

CT     69.80%   % reporting 8-10 Adult
DE1     74.95%   % reporting 8-10 Adults and Children
MD     66%   % reporting 8,9, 10 Adult
MI 66%   66.40%   % reporting 8-10 Adult
NM     72.36%   % reporting 8-10 Adult
NY 69%   65%   % reporting 8,9, or 10 Adults
PA     70.16%   measure is % reporting 8-10 Adult
VA     67.00%   % reporting 8-10 Adults
WI1 85.90%   86.20%   % reporting 8-10 Adults and Children
MA 56%   55%   % reporting 9 or 10 Adults
MN1     48%   % reporting 9 or 10 Adults and Children
NJ     44%   % reporting 9 or 10 Adults
OH     42.90%   % reporting 9 or 10 Adults
RI     50.22%   % reporting 9 or 10 Adult
TN     47.98%   % reporting 9 or 10 Adult
WA     42%   % reporting 9-10 in 2007 Adults

 

Figure 13: Overall Satisfaction with Personal Doctor for Adults

Figure 13: Overall Satisfaction with Personal Doctor for Adults

Source: Aggregate state data.

Note: CAHPS question is: "On a scale from 0 to 10, with 10 being the highest, overall, how satisfied are you with your personal doctor?"

1Population includes children.

 

 

Figure 13: Overall Satisfaction with Personal Doctor for Adults
State 2001-2005 Year Reported 2006-2010 Year Reported Percent Reporting Population

Source: Aggregate state data.

Note: CAHPS question is: "On a scale from 0 to 10, with 10 being the highest, overall, how satisfied are you with your personal doctor?"

1Population includes children.
Medicaid 2010 National Average for Rating 8-10 = 76.4; Rating 9-10 = 61.1%
Commercial 2010 National Average for Rating 8-10 = 83.2%; Rating 9-10=65.0%

CT     75.50% 2010 % reporting 8-10 Adult
DE1     77.30% 2010 % reporting 8-10 Adults and Children
MD     75% 2010 % reporting 8-10 Adult
MI 72% 2003 74.20% 2010 % reporting 8-10 Adult
NM     79.71% 2010 % reporting 8-10 Adult
NY1 79.20% 2001 74% 2009 % reporting 8-10 Adults and Children
PA     77.26% 2010 % reporting 8-10 Adult
VA     75% 2001 % reporting 8-10 Adults
MA 59% 2001 62% 2008 % reporting 9 or 10 Adults
MN1     67% 2009 % reporting 9 or 10 Adults and Children
NJ     49% 2009 % reporting 9 or 10 Adults
OH     61% 2008 % reporting 9 or 10 Adults
RI     61.80% 2010 % reporting 9 or 10 Adult
TN     62.33% 2010 % reporting 9 or 10 Adult
WA     58% 2007 % reporting 9-10 in 2007 Adults

 

Figure 14: Overall Satisfaction with Specialist Care for Adults

igure 14: Overall Satisfaction with Specialist Care for Adults

Source: Aggregate state data.

Note: CAHPS question is: "On a scale from 0 to 10, with 10 being the highest, overall, how satisfied are you with your specialist care?"

1Population includes children.

 

Figure 14: Overall Satisfaction with Specialist Care for Adults
State 2001-2005 Year reporting 2006-2010 Year Reporting Percent Reported Population

Source: Aggregate state data.

Note: CAHPS question is: "On a scale from 0 to 10, with 10 being the highest, overall, how satisfied are you with your specialist care?"

1Population includes children.
Medicaid 2010 National Average for Rating 8-10 = 76.9; Rating 9-10 = 61.3
Commercial 2010 National Average for Rating 8-10 = 82.3%; Rating 9-10=64.1%

CT     74.40% 2010 % reporting 8-10 Adult
DE     77.30% 2010 % reporting 8-10 Adult and Children
MD     76% 2010 % reporting 8-10 Adult
MI 72% 2003 77% 2010 % reporting 8-10 Adult
NM     76.84% 2010 % reporting 8-10 Adult
NY 72.20% 2001 67% 2009 % reporting 8-10 Adults and Children
PA     77.18% 2010 % reporting 8-10 in 2010 Adult
VA     78% 2010 % reporting 8-10  
MA 56% 2002 57% 2006 % reporting 9 or 10 Adults
MN     59% 2009 % reporting 9 or 10 Adults and Children
NJ     58% 2009 % reporting 9 or 10 Adults
OH     59.7% 2009 % reporting 9 or 10 Adult
RI     55.84% 2010 % reporting 9 or 10 Adult
TN     65.04% 2010 % reporting 9 or 10 Adult
WA     52% 2007 % reporting 9-10 in 2007 Adults

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