The National Committee on Quality Assurance (NCQA) is a national not-for-profit company that maintains quality data on health plans from across the country. NCQA has many quality measures that they ask each health plan to report on yearly. The NCQA quality measures are called HEDIS (HealthPlan Effectiveness Data Information Set). This lets everyone see how health plans compare to each other in different areas of healthcare quality. HEDIS has measures for preventive care (adults and children), immunizations for all ages, care of pregnant women, and the care of diseases like asthma and diabetes. The results are audited and reported to NCQA. This allows health plans and the public to gauge the quality of the health plan’s care and services. It also shows the health plans where there is room for improvement. MedStar Family Choice is always looking at many quality measures and using that information to focus on ways to improve care, services, and health outcomes for its members.

MedStar Family Choice reported all measures required by NCQA for Medicaid plans and any extra measures required by the Maryland Department of Health.

We are happy to report that MedStar Family Choice scored above or met the National Average for HEDIS measurement year 2025 in the following areas*: 

  • Well Child Care for members less than 30 months of age (W30)
  • Lead Screening in Children (LSC)
  • Childhood Immunization Status (CIS) and Immunizations for Adolescents (IMA) 
  • Prenatal and Postpartum Care (PPC)
  • Breast Cancer Screening (BCS) and Cervical Cancer Screening (CCS) for women
  • Colorectal Cancer Screening (COL)
  • Glycemic Status for Patients with Diabetes – Control (<8%) (GSD)
  • Kidney Health Evaluation for members with diabetes (KED) 
  • Blood Pressure Control for Members with Diabetes (BPD)

*This is not an all-inclusive list

Proposed Focus for HEDIS 2026:

MedStar Family Choice targets areas that can be improved so that the plan can maintain its quality scores and continue to improve.

Some key focus areas for 2026 include:

  • Wellness, Immunizations (Flu vaccine for all ages), and PCP Visits for Adults and Children
  • Diabetes Care (A1c Control, Kidney Health Evaluations, and Dilated Eye Exam)
  • Cervical Cancer, Colorectal Cancer, and Chlamydia Screenings
  • Chronic care condition such as diabetes and hypertension monitoring services and control
  • Appropriate use of antibiotics and radiology services

As we continue to improve and strive for high scores, your dedication to quality health care is very much appreciated.

HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).

Information current as of: