The State of Health Care Quality Report outlines the latest HEDIS® measures and definitions and provides an annual summary of national performance for key HEDIS and CAHPS® measures. The report offers insights into critical health care areas such as cardiovascular disease, diabetes, cancer screening, and patient experience. It summarizes performance from the previous calendar year and documents nearly two decades of results for older measures.
While the report highlights national performance, you can explore additional benchmarks, plan-level results, and insights into year-over-year trending impacts by purchasing access to NCQA’s Quality Compass®.
Key Notes:
- The State of Healthcare report is updated annually with the latest performance data.
- The data presented does not account for changes to the measure specifications that may impact year-over-year comparisons. For trending implications, inquire now about access to NCQA’s Quality Compass.
Access/Availability of Care
Effectiveness of Care
Behavioral Health
- Adherence to Antipsychotic Medications for Individuals With Schizophrenia (SAA)
- Cardiovascular Monitoring for People With Cardiovascular Disease and Schizophrenia (SMC)
- Diabetes Monitoring for People with Diabetes and Schizophrenia (SMD)
- Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD)
- Diagnosed Mental Health Disorders (DMH)
- Diagnosed Substance Use Disorders (DSU)
- Follow-Up After Emergency Department Visit for Substance Use (FUA)
- Follow-Up After Emergency Department Visit for Mental Illness (FUM)
- Follow-Up After High-Intensity Care for Substance Use Disorder (FUI)
- Follow-Up After Hospitalization for Mental Illness (FUH)
- Pharmacotherapy for Opioid Use Disorder (POD)
Care Coordination
- Advance Care Planning (ACP)
- Follow-Up After Emergency Department Visit for People With High-Risk Multiple Chronic Conditions (FMC)
- Transitions of Care (TRC)
Cardiovascular Conditions
- Cardiac Rehabilitation (CRE)
- Controlling High Blood Pressure (CBP)
- Persistence of Beta-Blocker Treatment After a Heart Attack (PBH)
- Statin Therapy for Patients with Cardiovascular Disease (SPC)
Diabetes
- Blood Pressure Control for Patients With Diabetes (BPD)
- Eye Exam for Patients With Diabetes (EED)
- Glycemic Status Assessment for Patients With Diabetes (GSD)
- Kidney Health Evaluation for Patients With Diabetes (KED)
- Statin Therapy for Patients with Diabetes (SPD)
Measures Collected Through the CAHPS® Health Plan Survey
Measures Collected Through the Medicare Health Outcomes Survey
- Fall Risk Management (FRM)
- Management of Urinary Incontinence in Older Adults (MUI)
- Medicare Health Outcomes Survey (HOS)
- Physical Activity in Older Adults (PAO)
Musculoskeletal Conditions
- Osteoporosis Management In Women Who Had a Fracture (OMW)
- Osteoporosis Screening in Older Women (OSW)
Overuse/Appropriateness
- Appropriate Treatment for Children With Upper Respiratory Infection (URI)
- Avoidance of Antibiotic Treatment in Adults With Acute Bronchitis (AAB)
- Deprescribing of Benzodiazepines in Older Adults (DBO) 
- Potentially Harmful Drug-Disease Interactions in Older Adults (DDE)
- Non-Recommended PSA-Based Screening in Older Men (PSA)
- Risk of Continued Opioid Use (COU)
- Use of High-Risk Medications in Older Adults (DAE)
- Use of Imaging Studies for Low Back Pain (LBP)
- Use of Opioids at High Dosage (HDO)
- Use of Opioids from Multiple Providers (UOP)
Prevention and Screening
- Care for Older Adults (COA)
- Chlamydia Screening (CHL)
- Lead Screening in Children (LSC)
- Oral Evaluation, Dental Services (OED)
- Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC)
Respiratory Conditions
- Appropriate Testing for Pharyngitis (CWP)
- Asthma Medication Ratio (AMR)
- Pharmacotherapy Management of COPD Exacerbation (PCE)
Experience of Care
Measures Reported Using Electronic Clinical Data Systems
- Adult Immunization Status (AIS-E)
- Blood Pressure Control for Patients With Hypertension (BPC-E) 
- Breast Cancer Screening (BCS-E)
- Cervical Cancer Screening (CCS-E) 
- Childhood Immunization Status (CIS-E) 
- Colorectal Cancer Screening (COL-E)
- Depression Remission or Response for Adolescents and Adults (DRR-E)
- Depression Screening and Follow-Up for Adolescents and Adults (DSF-E)
- Documented Assessment After Mammogram (DBM-E)
- Follow-Up After Abnormal Mammogram Assessment (FMA-E)
- Follow-Up Care for Children Prescribed ADHD Medication (ADD-E)Â
- Immunizations for Adolescents (IMA-E)
- Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM-E)
- Postpartum Depression Screening and Follow-up (PDS-E)
- Prenatal Depression Screening and Follow-up (PND-E)
- Prenatal Immunization Status (PRS-E)
- Social Need Screening and Intervention (SNS-E)
- Unhealthy Alcohol Use Screening and Follow-Up (ASF-E)
- Utilization of PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults (DMS-E)
Utilization and Risk Adjusted Utilization
Utilization
- Antibiotic Utilization for Respiratory Conditions (AXR)
- Child and Adolescent Well-Care Visits (WCV)
- Well-Child Visits in the First 30 Months of Life (W30)
Risk-Adjusted Utilization
- Acute Hospital Utilization (AHU)
- Emergency Department Visits for Hypoglycemia in Older Adults With Diabetes (EDH)Â
- Emergency Department Utilization (EDU)
- Hospitalization Following Discharge From a Skilled Nursing Facility (HFS)
- Hospitalization for Potentially Preventable Complications (HPC)
- Plan All-Cause Readmissions (PCR)
Retired Measures
Access/Availability of Care
Effectiveness of Care
Behavioral Health
- Antidepressant Medication Management (AMM)
- Follow-Up Care for Children Prescribed ADHD Medication (ADD)
- Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM)
Care Coordination
Measures Collected Through the CAHPS® Health Plan Survey
Medication Management and Care Coordination
Overuse/Appropriateness
- Use of Multiple Concurrent Antipsychotics in Children and Adolescents (APC)
- Non-Recommended Cervical Cancer Screening in Adolescent Females (NCS)
Prevention and Screening
- Adult BMI Assessment (ABA)
- Breast Cancer Screening (BCS)
- Cervical Cancer Screening (CCS)
- Childhood Immunization Status (CIS)
- Colorectal Cancer Screening (COL)
- Immunizations for Adolescents (IMA)
Respiratory Conditions
Utilization and Risk Adjusted Utilization
Utilization
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).
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