About HEDIS By Geography

Current clinical quality performance measurement efforts – most often anchored by the Healthcare Effectiveness Data and Information Set (HEDIS) – focus on health plans and physician organizations, resulting in public reporting of plan- and physician organization-specific results. While useful for informing provider quality improvement efforts and consumer decision-making, current results do not allow for a clear picture of population health in a geographic area.

This project fills this information gap in California by collecting from health plans' HEDIS results by geography and product line, aggregating the results in various ways, and making the results available to interested stakeholders.

Participating Health Plans:

About the Data

The clinical and resource use data displayed on the map was provided to IHA by 11 health plans in California for care delivered during calendar year 2013. Data were suppressed in a geographic unit when provided by only one plan, or when the denominator of the rate included less than 30 people. A missing rate (transparent on map) could indicate suppressed data, or the lack of any data in that region.

Not all measures were reported for every product line. The table below shows which product lines have data associated with each measure.

Category Measure Commercial (HMO and PPO) Medicare Advantage Managed Medicaid (Medi-Cal)
Clinical Breast Cancer Screening
Colorectal Cancer Screening
Diabetes Care: HbA1c Poor Control (>9.0%)
Diabetes Care: HbA1c Screening
Diabetes Care: Nephropathy Monitoring
Medication Management for People with Asthma
Resource Use All Cause Readmissions
  SPD and non-SPD breakouts
Emergency Department Visits
  SPD and non-SPD breakouts
Inpatient Utilization: Bed Days
  SPD and non-SPD breakouts

Hospital Referal Regions (HRRs) and Hospital Service Areas (HSAs) are defined by the Dartmouth Atlas. More information is available here.

The demographic data was downloaded at the zip-code level from the Census Bureau website. The data is from the 2012 American Community Survey.

A data dictionary can be downloaded here.

About IHA

IHA is a California-based nonprofit association working to actively convene all healthcare parties for cross sector collaboration on health care topics. IHA administers regional and statewide programs and serves as an incubator for pilot programs and projects.


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