Quality Matters: HEDIS Results
Healthcare Effectiveness Data and Information Set
Monitoring Clinical Quality
Commercial HMO/POS HEDIS® Selected Results
Quality Matters – How does Quartz Stack up?
- The National Committee for Quality Assurance (NCQA) is a non-profit organization dedicated to improving health care quality through rigorous evaluations of contracted hospitals, clinics, and practitioners, health plan processes, and customer feedback. By earning accreditation through NCQA, Quartz demonstrates its commitment to offering the best in service and care for all of our member’s/participant’s needs. Quartz is accredited for our Commercial, Marketplace, and Medicare products. In 2022, Quartz received 4.5 stars for Commercial, 4.5 stars for Medicare WI/IA and 4.5 stars for Medicare MN, top score being 5 stars.
- Quartz’s health plans also utilize NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) as a measurement tool. HEDIS is commonly used to compare participating health plans on an equal level. Quartz Commercial, Medicare, Medicaid, and Marketplace plans are measured and rated. HEDIS® is used by more than 90% of U.S. health plans to measure performance on important dimensions of care and service such as the effectiveness of care, appropriateness of care, access and availability of care, utilization, and experience of care. It provides the same type of performance information for all health plans, making it easy to compare plans.
- Quartz Badger Plus HMO is currently ranked a top BadgerCare Plus HMO in Wisconsin. In 2021, Quartz received a total of 4.5 out of 5 stars by the Department of Human Services (DHS). Categories rated include Staying Healthy, Living With Illness, Mental Health, Pregnancy & Birth, and Emergency Department.
- Quartz Quality Rating System (QRS) 2022 Rating for ACA Individual plans is at 4 out of 5 stars according to CMS. Categories rated include Member Experience, Medical Care and Plan Administration
| Quartz’s Top-Performing Measures | NCQA Rating (out of 5.0) |
|---|---|
| Well-Child Visits, Infants | 5.0 |
| Childhood Immunizations Status – Combo 10 | 5.0 |
| Adolescent Immunizations | 4.0 |
| BMI Percentile Assessment | 4.0 |
| Prenatal Care | 5.0 |
| Postpartum Care | 5.0 |
| Breast Cancer Screening | 5.0 |
| Colorectal Cancer Screening | 5.0 |
| Cervical Cancer Screening | 5.0 |
| Adult BMI Assessment | 5.0 |
| Flu Shots for Adults | 4.0 |
| Asthma Control | 5.0 |
| Diabetes – Blood Pressure Control, Eye Exams, Glucose Control, Received Statin Therapy, Statin Adherence 80% | 5.0 |
| Heart Disease – Blood Pressure, Received Statin Therapy, Statin Adherence 80% | 4.5 |
| Follow-Up After Hospitalization for Mental Illness | 5.0 |
| First-Line Psychosocial Care for Youth on Antipsychotic Medications | 5.0 |
| Appropriate Antibiotic Use, Adults with Acute Bronchitis | 4.0 |
| Bronchodilator After Hospitalization for Acute COPD | 4.0 |
| Appropriate Antibiotic Use, Children with Colds | 4.0 |
| Appropriate Use of Imaging Studies for Low Back Pain | 4.0 |