Healthcare Ensuring Quality Healthcare
Results for coverage in 20852
Healthcare Quality Results
To help you select a health plan that meets your needs and your family’s healthcare needs, we developed a quality evaluation system using Healthcare Effectiveness Data and Information Set (HEDIS®) metrics that allows you to gauge health plan performance for significant health issues, including:
- Preventive Care
- Chronic Disease Management
- Medication Use
- Behavioral Health
- Utilization Management
HEDIS metrics are a set of standardized performance measures that allow you to compare Federal Employees Health Benefits (FEHB) health plan performance to industry benchmark percentiles of plan performance using the key below. Plans are displayed based on their average performance on the first three quality measures.
| Plan Name |
Controlling High Blood Pressure 
People with high blood pressure receive effective treatment. |
Hemoglobin A1c Control for Patients with Diabetes
Do people with diabetes have their condition under control? |
Timeliness of Prenatal Care
Pregnant women receive care in the first trimester. |
Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis Ages 18 to 64
Appropriate use of antibiotics for acute bronchitis. |
Asthma Medication Ratio
Appropriate ratio of controller medications to total asthma medications. |
Breast Cancer Screening
Do women who need screening mammograms get them? |
Follow Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence 30 day
Follow up appointment within 30 days of discharge. |
Follow Up After Emergency Department Visit for Mental Illness 30 day
Follow up appointment within 30 days of discharge. |
Childhood Immunization Status—Combination 10
Recommended well child visits completed. |
Use of Imaging Studies for Low Back Pain
Appropriate treatment of lower back pain. |
|---|---|---|---|---|---|---|---|---|---|---|
|
Key:
Outstanding
Excellent
Good
Fair
Poor
NA
Note: NA is displayed if a plan did not report or is unable to report a result in this coverage area. |
||||||||||
| APWU Health Plan, High (47) | Fair | Poor | Fair | Poor | Good | Poor | Excellent | Poor | Poor | Fair |
| APWU Health Plan, CDHP (47) | Fair | Fair | Fair | Good | Poor | Poor | Poor | Fair | Fair | Good |
| MHBP Consumer Option, HDHP (48) | Good | Excellent | Excellent | Fair | Good | Poor | Good | Poor | Fair | Good |
| Kaiser Permanente - Mid-Atlantic States, High (E3) | Outstanding | Excellent | Outstanding | Outstanding | Outstanding | Outstanding | Good | Fair | Outstanding | Excellent |
| Kaiser Permanente - Mid-Atlantic States, Standard (E3) | Outstanding | Excellent | Outstanding | Outstanding | Outstanding | Outstanding | Good | Fair | Outstanding | Excellent |
| NALC, High (32) | Good | Good | Fair | Fair | Good | Poor | Fair | Fair | Fair | Good |
| NALC, CDHP (32) | Poor | Poor | Poor | Good | Poor | Poor | Poor | Poor | Poor | Good |
| Compass Rose Health Plan, High (42) | Good | Fair | Fair | Good | Outstanding | Good | Data Not Available | Good | Poor | Fair |
| Panama Canal Area Benefit Plan, High (43) | Poor | Outstanding | Data Not Available | Data Not Available | Data Not Available | Poor | Data Not Available | Data Not Available | Data Not Available | Outstanding |
| SAMBA, High (44) | Fair | Fair | Fair | Fair | Outstanding | Fair | Excellent | Data Not Available | Fair | Fair |
| Aetna HealthFund HDHP and Aetna Direct Plan, HDHP (22) | Fair | Poor | Fair | Poor | Good | Fair | Outstanding | Good | Fair | Excellent |
| GEHA Benefit Plan, HDHP (34) | Good | Fair | Good | Poor | Excellent | Fair | Good | Fair | Fair | Good |
| MHBP - Standard and Value, Standard (45) | Good | Excellent | Excellent | Fair | Good | Poor | Good | Poor | Fair | Good |
| UnitedHealthcare Insurance Company, Inc. Choice Primary , High (Y8) | Good | Good | Good | Good | Poor | Good | Fair | Fair | Good | Excellent |
| Aetna Open Access, Saver (QQ) | Poor | Fair | Fair | Poor | Fair | Good | Fair | Fair | Good | Fair |
| UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)), HDHP (V4) | Fair | Fair | Excellent | Excellent | Poor | Good | Data Not Available | Data Not Available | Outstanding | Good |
| CareFirst BlueChoice, HDHP (B6) | Excellent | Outstanding | Good | Poor | Outstanding | Excellent | Outstanding | Good | Good | Poor |
| CareFirst BlueChoice, Blue Value Plus (B6) | Excellent | Outstanding | Good | Poor | Outstanding | Excellent | Outstanding | Good | Good | Poor |
| Kaiser Permanente - Mid-Atlantic States, Prosper (T7) | Outstanding | Excellent | Outstanding | Outstanding | Outstanding | Outstanding | Good | Fair | Outstanding | Excellent |
| UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced), Value (L9) | Fair | Fair | Excellent | Excellent | Poor | Good | Data Not Available | Data Not Available | Outstanding | Good |
| Aetna Advantage Plan, Advantage (Z2) | Poor | Fair | Fair | Good | Fair | Fair | Good | Fair | Excellent | Fair |
| GEHA Indemnity Benefit Plan, Elevate Plus (25) | Fair | Poor | Fair | Excellent | Good | Poor | Excellent | Fair | Fair | Excellent |
| Foreign Service Benefit Plan, High (40) | Good | Outstanding | Fair | Outstanding | Outstanding | Fair | Excellent | Good | Fair | Excellent |
| MHBP - Standard and Value, Value (41) | Good | Excellent | Excellent | Fair | Good | Poor | Good | Poor | Fair | Good |
| SAMBA, Standard (44) | Fair | Fair | Fair | Fair | Outstanding | Fair | Excellent | Data Not Available | Fair | Fair |
| GEHA Benefit Plan, Standard (31) | Good | Fair | Good | Poor | Excellent | Fair | Good | Fair | Fair | Good |
| GEHA Indemnity Benefit Plan, Elevate (25) | Fair | Poor | Fair | Excellent | Good | Poor | Excellent | Fair | Fair | Excellent |
| CareFirst BlueChoice, Standard (2G) | Excellent | Outstanding | Good | Poor | Outstanding | Excellent | Outstanding | Good | Good | Poor |
| GEHA Benefit Plan, High (31) | Good | Fair | Good | Poor | Excellent | Fair | Good | Fair | Fair | Good |
| UnitedHealthcare Insurance Company, Inc. Choice Plus Primary, High (AS) | Fair | Good | Good | Poor | Fair | Poor | Fair | Poor | Fair | Poor |
| Blue Cross and Blue Shield Service Benefit Plan, Standard (10) | Good | Fair | Good | Poor | Good | Good | Good | Good | Good | Fair |
| Blue Cross and Blue Shield Service Benefit Plan, Basic (11) | Good | Fair | Good | Poor | Good | Good | Good | Good | Good | Fair |
| Blue Cross and Blue Shield Service Benefit Plan, FEP Blue Focus (13) | Good | Fair | Good | Poor | Good | Good | Good | Good | Good | Fair |
| Aetna HealthFund HDHP and Aetna Direct Plan, CDHP (N6) | Fair | Poor | Poor | Poor | Fair | Poor | Data Not Available | Data Not Available | Poor | Poor |
| Aetna HealthFund CDHP and Aetna Value Plan, CDHP (F5) | Fair | Poor | Fair | Poor | Fair | Poor | Fair | Poor | Poor | Poor |
| Aetna HealthFund CDHP and Aetna Value Plan, Value (F5) | Fair | Poor | Fair | Poor | Fair | Poor | Fair | Poor | Poor | Poor |
| Aetna Open Access, High (JN) | Poor | Fair | Fair | Poor | Fair | Good | Fair | Fair | Good | Fair |
| M.D. IPA, High (JP) | Good | Good | Data Not Available | Fair | Fair | Fair | Data Not Available | Data Not Available | Data Not Available | Good |
| UnitedHealthcare Insurance Company, Inc. (Choice Open Access) , High (LR) | Good | Outstanding | Good | Good | Poor | Excellent | Fair | Fair | Excellent | Fair |
| Aetna Open Access, Basic (JN) | Poor | Fair | Fair | Poor | Fair | Good | Fair | Fair | Good | Fair |
Consumer Satisfaction Survey Results
Each year Federal Employees Health Benefits (FEHB) plans send the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey to a sample of plan members to evaluate their health plan experiences in key areas, including:
- Communication
- Access
- Claims
- Member Experience/Engagement
CAHPS® metrics are a set of standardized performance measures that allow you to compare Federal Employees Health Benefits (FEHB) health plan performance to industry benchmark percentiles of plan performance using the key below. Plans are displayed based on their average performance on the first three quality measures.
| Plan Name |
Getting Needed Care
Members report getting the care they need. |
Claims Processing
How quickly do customers say the plan handles claims? |
Overall Plan Satisfaction
How pleased are customers with the plan overall? |
Coordination of Care
Members say that their doctors know about care from other providers. |
||||||
|---|---|---|---|---|---|---|---|---|---|---|
|
Key:
Outstanding
Excellent
Good
Fair
Poor
NA
Note: NA is displayed if a plan did not report or is unable to report a result in this coverage area. |
||||||||||
| Blue Cross and Blue Shield Service Benefit Plan, Standard (10) | Excellent | Excellent | Outstanding | Good | ||||||
| Blue Cross and Blue Shield Service Benefit Plan, Basic (11) | Good | Good | Outstanding | Poor | ||||||
| Blue Cross and Blue Shield Service Benefit Plan, FEP Blue Focus (13) | Good | Fair | Good | Fair | ||||||
| Aetna HealthFund HDHP and Aetna Direct Plan, HDHP (22) | Excellent | Data Not Available | Excellent | Fair | ||||||
| GEHA Indemnity Benefit Plan, Elevate Plus (25) | Poor | Data Not Available | Fair | Data Not Available | ||||||
| GEHA Indemnity Benefit Plan, Elevate (25) | Fair | Data Not Available | Fair | Data Not Available | ||||||
| CareFirst BlueChoice, Standard (2G) | Fair | Data Not Available | Excellent | Fair | ||||||
| GEHA Benefit Plan, High (31) | Excellent | Good | Outstanding | Poor | ||||||
| GEHA Benefit Plan, Standard (31) | Poor | Data Not Available | Fair | Data Not Available | ||||||
| NALC, High (32) | Good | Fair | Outstanding | Good | ||||||
| NALC, CDHP (32) | Outstanding | Data Not Available | Fair | Data Not Available | ||||||
| GEHA Benefit Plan, HDHP (34) | Fair | Poor | Poor | Fair | ||||||
| Foreign Service Benefit Plan, High (40) | Poor | Poor | Good | Poor | ||||||
| MHBP - Standard and Value, Value (41) | Outstanding | Data Not Available | Excellent | Data Not Available | ||||||
| Compass Rose Health Plan, High (42) | Good | Fair | Outstanding | Poor | ||||||
| Panama Canal Area Benefit Plan, High (43) | Outstanding | Poor | Outstanding | Excellent | ||||||
| SAMBA, High (44) | Outstanding | Fair | Outstanding | Fair | ||||||
| SAMBA, Standard (44) | Good | Good | Outstanding | Poor | ||||||
| MHBP - Standard and Value, Standard (45) | Excellent | Outstanding | Outstanding | Good | ||||||
| APWU Health Plan, High (47) | Good | Data Not Available | Excellent | Data Not Available | ||||||
| APWU Health Plan, CDHP (47) | Good | Poor | Excellent | Fair | ||||||
| MHBP Consumer Option, HDHP (48) | Fair | Data Not Available | Excellent | Data Not Available | ||||||
| UnitedHealthcare Insurance Company, Inc. Choice Plus Primary, High (AS) | Excellent | Data Not Available | Good | Data Not Available | ||||||
| CareFirst BlueChoice, HDHP (B6) | Fair | Data Not Available | Excellent | Fair | ||||||
| CareFirst BlueChoice, Blue Value Plus (B6) | Fair | Data Not Available | Excellent | Fair | ||||||
| Kaiser Permanente - Mid-Atlantic States, High (E3) | Poor | Data Not Available | Excellent | Fair | ||||||
| Kaiser Permanente - Mid-Atlantic States, Standard (E3) | Poor | Data Not Available | Excellent | Fair | ||||||
| Aetna HealthFund CDHP and Aetna Value Plan, CDHP (F5) | Excellent | Data Not Available | Excellent | Fair | ||||||
| Aetna HealthFund CDHP and Aetna Value Plan, Value (F5) | Excellent | Data Not Available | Excellent | Fair | ||||||
| Aetna Open Access, High (JN) | Excellent | Data Not Available | Good | Poor | ||||||
| Aetna Open Access, Basic (JN) | Excellent | Data Not Available | Good | Poor | ||||||
| M.D. IPA, High (JP) | Outstanding | Good | Excellent | Good | ||||||
| UnitedHealthcare Insurance Company, Inc. (Choice Plus Advanced), Value (L9) | Excellent | Data Not Available | Good | Data Not Available | ||||||
| UnitedHealthcare Insurance Company, Inc. (Choice Open Access) , High (LR) | Excellent | Data Not Available | Good | Data Not Available | ||||||
| Aetna HealthFund HDHP and Aetna Direct Plan, CDHP (N6) | Excellent | Data Not Available | Excellent | Fair | ||||||
| Aetna Open Access, Saver (QQ) | Excellent | Data Not Available | Good | Poor | ||||||
| Kaiser Permanente - Mid-Atlantic States, Prosper (T7) | Poor | Data Not Available | Excellent | Fair | ||||||
| UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)), HDHP (V4) | Excellent | Data Not Available | Good | Data Not Available | ||||||
| UnitedHealthcare Insurance Company, Inc. Choice Primary , High (Y8) | Excellent | Data Not Available | Good | Data Not Available | ||||||
| Aetna Advantage Plan, Advantage (Z2) | Excellent | Data Not Available | Excellent | Fair | ||||||
- Healthcare Effectiveness Data and Information Set (HEDIS®), source of the data presented on this web page, is a registered trademark of the National Committee for Quality Assurance (NCQA). View more information on the collection and assessment of HEDIS.
- The HEDIS® measures and specifications were developed by and are owned by the National Committee for Quality Assurance ("NCQA"). The HEDIS measures and specifications are not clinical guidelines and do not establish standards of medical care. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures or any data or rates calculated using the HEDIS measures and specifications and NCQA has no liability to anyone who relies on such measures or specifications. © 2012-2015 National Committee for Quality Assurance, all rights reserved.
- The data contained herein is protected by copyright and other intellectual property laws or treatises. Reproduction or use of the data requires permission of NCQA and is subject to a license at the discretion of NCQA. Unauthorized copying or use if prohibited.