Table 4.

Quality Measure Specifications

Quality measures
Measure name	Definition*
Breast Cancer Screening	Percentage of women aged 40–69 years who had at least one mammogram in the measurement year or year prior to the measurement year
Cervical Cancer Screening	Percentage of women aged 21–64 years who had at least one Pap test in the measurement year or 2 years prior to the measurement year
Colorectal Cancer Screening	Percentage of adults 50 to 80 years of age who had one or more of the following during the measurement year: fecal occult blood test, flexible sigmoidoscopy, double contrast barium enema or air contrast barium enema, or colonoscopy
Chlamydia Screening	Percentage of sexually active women ages 16 to 24 who had at least one test for chlamydia during the measurement year
Comprehensive Diabetes Care: HbA1c Testing	Percentage of patients aged 18–75 years with diabetes (type 1 and type 2) who had a hemoglobin A1c test during the measurement year
Comprehensive Diabetes Care: Eye Exams	Percentage of patients aged 18–75 years with diabetes (type 1 and type 2) who had a retinal or dilated eye exam by an eye care professional in the measurement year or a negative retinal exam (no evidence of retinopathy) by an eye care professional in the measurement year
Comprehensive Diabetes Care: Cholesterol Screening	Percentage of patients aged 18–75 years with diabetes (type 1 and type 2) who had a low-density lipoprotein cholesterol test during the measurement year
Comprehensive Diabetes Care: Monitoring Diabetic Nephropathy	Percentage of patients aged 18–75 years with diabetes (type 1 and type 2) who received nephropathy screening, had a nephrologist visit, or had evidence of nephropathy as documented through administrative data during the measurement year
Use of Appropriate Medications for People With Asthma	Percentage of patients aged 5–56 years of age during the measurement year who were identified as having persistent asthma and who were appropriately prescribed medication during the measurement year

Definitions taken from National Committee for Quality Assurance (NCQA). HEDIS 2009. Health plan employer data & information set. Vol. 2, Technical specifications. Washington (DC): National Committee for Quality Assurance (NCQA); 2009. Detailed lists of comorbid conditions, competing diagnoses, and other exclusion criteria are contained in the original measure documentation available from the NCQA

*One of the health plans contributed only 18 months of pre-intervention claims data. Therefore, all quality measures for this plan were calculated using an 18-month look-back period (rather than 2 years) when applicable