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 quality measures are rolled up in a tool called HEDIS. This lets everyone see how health plans compare to each other in different areas of healthcare. HEDIS has measures for preventive care (adults and children), immunizations of children and teens, care of pregnant women, and the care of diseases like asthma and diabetes. The results are audited and reported to NCQA.

MedStar Family Choice reported all measures required for Medicaid plans to get NCQA accreditation 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 Maryland Average for HEDIS 2024 in the following areas:

 

  • Lead Screening in Children (LSC)

  • Breast Cancer Screening (BCS)

  • Pharmacotherapy Management of COPD Exacerbation - Bronchodilator (PCE)

  • Persistence of Beta-Blocker Treatment After a Heart Attack (PBH)

  • Statin Therapy for Patients with Cardiovascular Disease - Received Therapy - Total (SPC)

  • Hemoglobin A1c Control for Patients with Diabetes – Control (<8%) (HBD)

  • Prenatal and Postpartum Care

  • Childhood Immunization Status (CIS)

  • Blood Pressure Control for Members with Diabetes or without Diabetes

 

Proposed Focus for HEDIS 2026:

MedStar Family Choice targets areas we can be improved or where improvement can be kept and grown more:

 

  • 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

  • Medications for Asthma, Diabetes, and Cholesterol (adherence)

  • Appropriate Testing for Pharyngitis (CWP)

  • Pharmacotherapy Management of COPD Exacerbation – Systemic Corticosteroid (PCE)

  • Diagnosis of Mental Health and Substance Use disorders

  • Use of Opioids at High Dosage, Continued Use, and from Multiple Providers

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

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

Information current as of: