MDCH Recognizes High Performing Michigan Medicaid Health Plans Through HEDIS

Contact: T.J. Bucholz (517) 241-2112
Agency: Community Health

January 12, 2006

Michigan Medicaid’s 15 managed health care service plans have been objectively reviewed to have made significant improvements in childhood immunization status comprehensive diabetes care, and prenatal and postpartum care, according to national HEDIS performance data.

“The Michigan Department of Community Health (MDCH) commends the Medicaid health plans on their achievements in 2005,” said Janet Olszewski, MDCH Director. “We are proud of the Michigan Medicaid health plans and the work they and the health care provider community do every day to improve and protect the health and well being of Michigan’s most vulnerable citizens.”

The 2005 Health Plan Employer Data and Information Set (HEDIS) is developed and maintained by the National Committee for Quality Assurance (NCQA) and is the most widely used standardized performance measure in the managed care industry.

Michigan’s health plans currently provide services to more than 920,000 enrollees. Fifteen of Michigan’s 16 health plans have successfully completed the HEDIS review.

The 15 health plans also showed gains in their efforts to be successful in facilitating quality improvement for targeted performance measures. Annual quality improvement program evaluations found that all plans conducted numerous quality improvement initiatives, and most had disease management programs in place for such diseases as diabetes, asthma, hyperlipidemia, and hypertension.

The HEDIS measures also determined that most plans also had a prenatal care program to identify pregnant members and ensure delivery of the appropriate services, and operated a smoking cessation program aimed at identifying members who smoke and providing education and support services to assist in quitting.

For more information or to view the complete HEDIS report, please go to www.michigan.gov/mdch.