BOX 6.4 Selected Cancer-Specific (or Cancer-Relevant) HEDIS 3.0 Measures

Effectiveness of Care

  • Advising smokers to quit
  • Cervical cancer screening
  • Breast cancer screening
  • Number of people in the plan who smoke*
  • Smokers who quit*
  • Colorectal cancer screening*
  • Follow-up after an abnormal Pap smear.*
  • Follow-up after an abnormal mammogram (within 60 days)*
  • Stage at which breast cancer was detected*
  • Assessment of how breast cancer therapy affects the patient's ability to function*

Access to or Availability of Care

  • Adults' access to preventive ambulatory health services
  • Problems in obtaining care*

Satisfaction with the Experience of Care

  • Member satisfaction
  • Disenrollment*
  • Satisfaction with breast cancer treatment*

Health Plan Stability

  • Provider turnover

Health Plan Descriptive Information

  • Provider board certification or residency completion
  • Arrangements with public health, educational, and social service organizations

*  

Denotes testing set measures.

SOURCE: NCQA, 1998a.

The HEDIS cancer quality indicators have targeted early detection and diagnosis, not care received after cancer is diagnosed. NCQA's focus on early detection in cancer quality assessment appears to be related to its belief that ''early detection remains the most effective way of improving the outcomes of breast cancer'' (McGlynn, 1996). Treatment-related indicators are being evaluated—for example, assessment of the effect of breast cancer therapy on a woman's ability to function and patients' satisfaction with breast cancer treatment. NCQA has halted further work on the indicator related to the stage at which breast cancer is detected, because the incidence of breast cancer cases in most health plans is too low to make meaningful comparisons of stage at diagnosis across health plans (Schuster et al., 1998).

HEDIS is a voluntary system, although managed care plans are finding it increasingly necessary to participate to compete for patients. Some evidence suggests that most large employers are



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