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How We Measure Quality
We measure quality so you can find excellent, high-quality healthcare.
Find your primary care or women’s health doctor and see how they compare to local and national averages, which are measured by the National Committee for Quality Assurance (NCQA*).
The performance scores for each quality measure are based on information obtained through SelectHealth quality programs over a rolling 12-month period. Each score is compared to national benchmarks from the Healthcare Effectiveness Data and Information Set (HEDIS**), as well as to performance for similar specialty types in the SelectHealth networks.
**HEDIS is a registered trademark of the *NCQA and is designed to measure performance on important dimensions of care and services.
Blue ribbons indicate a provider’s quality performance nationally, based on their ratings:
- 1 blue ribbon < 25th percentile
- 2 blue ribbons ≥ 25th percentile and < 50th percentile
- 3 blue ribbons ≥ 50th percentile and < 75th percentile
- 4 blue ribbons ≥ 75th percentile and < 90th percentile
- 5 blue ribbons ≥ 90th percentile
If a provider does not have a quality rating, this usually means that he or she does not have enough volume of SelectHealth membership to gather data for the measures. It does not mean that the provider performs below those with ratings.
As you view these scores, remember that patients’ compliance can impact a physician’s score. For example, if a physician recommends a specific test or medical service, and the patient chooses not to have the test or service, the physician does not receive"credit" for that recommended care. This can negatively impact the provider’s overall score.
We measure in four main areas: 1) preventive screenings, 2) diabetes screenings, 3) medication adherence (whether a patient is taking medications as prescribed), and 4) pediatric monitoring.
How We Measure Quality
We measure quality so you can find excellent, high-quality healthcare.
Find your primary care or women’s health doctor and see how they compare to local and national averages, which are measured by the National Committee for Quality Assurance (NCQA*).
The performance scores for each quality measure are based on information obtained through SelectHealth quality programs over a rolling 12-month period. Each score is compared to national benchmarks from the Healthcare Effectiveness Data and Information Set (HEDIS**), as well as to performance for similar specialty types in the SelectHealth networks.
**HEDIS is a registered trademark of the *NCQA and is designed to measure performance on important dimensions of care and services.
Blue ribbons indicate a provider’s quality performance nationally, based on their ratings:
- 1 blue ribbon < 25th percentile
- 2 blue ribbons ≥ 25th percentile and < 50th percentile
- 3 blue ribbons ≥ 50th percentile and < 75th percentile
- 4 blue ribbons ≥ 75th percentile and < 90th percentile
- 5 blue ribbons ≥ 90th percentile
If a provider does not have a quality rating, this usually means that he or she does not have enough volume of SelectHealth membership to gather data for the measures. It does not mean that the provider performs below those with ratings.
As you view these scores, remember that patients’ compliance can impact a physician’s score. For example, if a physician recommends a specific test or medical service, and the patient chooses not to have the test or service, the physician does not receive"credit" for that recommended care. This can negatively impact the provider’s overall score.
We measure in four main areas: 1) preventive screenings, 2) diabetes screenings, 3) medication adherence (whether a patient is taking medications as prescribed), and 4) pediatric monitoring.
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