HEDIS measurements

Quality Report Cards (available below) rate the quality of care and service received by members of health plans in different states. To help you make comparisons between the experiences of Aetna members and those enrolled in other health plans, the report cards use a standard set of measures called the Healthcare Effectiveness Data and Information Set (HEDIS®).

HEDIS measures were developed by the National Committee for Quality Assurance (NCQA), an independent, nonprofit organization whose mission is to improve health care quality. These measures are used to rate health plans on quality of care, access to care, and member satisfaction with the plan. HEDIS measures are used by more than 90 percent of America’s health plans

HEDIS measures address many important health issues, including:

• Asthma medication use
• Persistence of beta-blocker treatment after a heart attack
• Control of high blood pressure
• Comprehensive diabetes care
• Breast and cervical cancer screening
• Colorectal cancer screening
• Antidepressant medication use
• Childhood immunization status
• Smoking cessation

You can use HEDIS results to evaluate the quality of different health plans and to help you choose a plan based on demonstrated value, not just on cost. To find more information about HEDIS measures and report cards, visit the NCQA website.

HEDIS Quality Report Cards can be viewed by state. Please select below for available state report cards. Please note that not all states offer report cards.

Aetna is a leader in promoting the measurement of quality and quality improvement in health care and is proud to be among the first health plans to publish HEDIS data.

The following are in PDF format 

Report card components 

Each HEDIS Quality Report Card includes information on access to care, preventive care and health screenings, maternity care, treatment of acute and chronic illness, mental health care and member satisfaction.

Access to care 

Report cards show how well the health plan provided people with access to needed care, including the percentage of adults and children who visited their doctor for routine or preventive care.

Guideline: Members should have access to their doctors for routine and preventive care.

Prevention and screening 

Report cards show the percentage of members who received proper health screenings.

Guidelines: Health plans should promote early detection of diseases by raising member awareness and encouraging screenings. Health plans should also encourage members to receive appropriate vaccinations, a proven defense against many illnesses.

Maternity care 

Report cards show the percentage of pregnant women who received proper maternity care.

Guideline: Health plans should encourage appropriate prenatal and postpartum care.

Treatment of acute and chronic illness 

Report cards show the percentage of members who receive proper treatment for acute and chronic conditions.

Guidelines: Health plans should measure how well doctors treat acute and chronic illnesses. Areas that health plans review include:

Treatment for cardiovascular conditions including high cholesterol and high blood pressure
Comprehensive treatment for diabetes
Use of appropriate medications for asthma

Mental health 

Report cards show the percentage of members who received treatment for mental illness and appropriate follow-up care.

Member satisfaction 

Report cards also show data on member satisfaction with the health plan and the doctors in its network. This information indicates how well the health plan meets members’ expectations.