This is the file for Certified Eligibles by Race/Ethnicity and Age Group

Category Topic Measure Dictionary

Health Care Quality Report Card

Explanation of the numeric Annotation Code, providing the reason that the health plan or medical group does not have a rating.

Annotation Explanation

Indicates whether the scores are related to quality of medical care (HEDIS data, IHA data, and IHAMEDICARE data), to patient experience (CAHPS data), or to total cost of care (IHATCC data).

Category Code

The overall star rating for each health plan or medical group for their quality of medical care or  patient experience scores.

Overall Ratings

Indicates which counties are served by the health plan or medical group.

County

The code used in each spreadsheet to represent the health plan or medical group.

Entity Code

The name of the health plan or medical group.

Entity Name

Indicates whether the entity is an HMO (Health Maintenance Organization), a PPO (Preferred Provider Organization), or a Medical Group.

Entity Type

Indicates if the health plan serves patients with Medicare health insurance or Commercial health insurance in each county they serve.

Insurance Type

Indicates the measure that the percentage rating refers to. See the Category_Topic_Measure Dictionary for the complete list of measures and definitions of each measure.

Measure Code

The percentage rating that each health plan or medical group received for each measure.

Measure Ratings

The star rating that each Medicare medical group received for each measure.

Medicare Star Rating

Indicates the topic that the star rating refers to. See the Category_Topic_Measure Dictionary for the complete list of topics and definitions of each topic.

Topic Code

The star rating that each health plan or medical group received for each topic.

Topic Ratings

health-care-quality-report-card

The scores show how well each health plan did at making sure adolescent or adult patients, who have an alcohol or other drug dependence diagnosis, started treatment services within 14 days of being diagnosed. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015.

The scores show how well each health plan did at making sure adolescent or adult patients, with an alcohol or other drug dependence diagnosis, had initial treatment within two weeks of diagnosis and had at least two follow-up treatment services within 30 days of their initial treatment. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015.

The scores show how well each health plan did at making sure patients diagnosed with depression received treatment during the acute phase (first 12 weeks) following the start of treatment. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015.

The scores show how well each health plan did at making sure patients who were treated for depression also remained on anti-depressant medication for 6 months following the start of treatment. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015.

The scores show how well each health plan did at making sure women (ages 56 to 79) and men (ages 46 to 79), who were at risk for heart problems, had their doctor or another provider talk with them about the pros and cons of taking aspirin as part of their heart care. The higher score means more patients got the right care at the right time. The scores are based on a survey of a sample of at least 100 health plan members in 2015.

Composite star rating calculation based on the health plan's scores for Asthma Medicine for Adults/Adolescents, Asthma Medicine for Children, Testing Lung Disease, Treating Lung Disease – Corticosteroid Medication, Treating Lung Disease – Bronchodilator Medication, and Treating Bronchitis: Getting the Right Care. The stars tell you how successful each health plan was at helping patients get the care they needed. More stars are better.

Star rating calculation based on the health plan's score for Asthma Medicine. The stars tell you how successful each medical group was at helping patients get the care they needed. More stars are better.

The scores show how well each medical group did at making sure patients, ages 5 through 64 who experienced frequent asthma symptoms, got the right combination of medicines — called controllers and relievers — for their asthma and knew when and how to use them properly. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 medical group patient records in 2015.

The scores show how well each health plan did at making sure members, ages 12 through 64 who experienced frequent asthma symptoms, got the right combination of medicines — called controllers and relievers — for their asthma and knew when and how to use them properly. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 health plan  member administrative records in 2015.

The scores show how well each health plan did at making sure children, ages 5 through 11, who have asthma got the right combination of medicine — called controllers and relievers — for their asthma. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015.

This star rating is based on the average amount that health plans and patients pay for all of the care for a year. Calculations include the average amount paid by health plans for things like check-ups and tests such as mammograms and colonoscopies plus the average amount paid by patients for things like co-pays and monthly insurance premiums. More stars are better, and indicate a lower average annual payment.

Composite star rating calculation based on the health plan's scores for Alcohol and Drug Dependence Treatment – Initiation Phase, Alcohol and Drug Dependence Treatment – Ongoing Phase, Antidepressant Medication – First three Months of Treatment, Antidepressant Medication – Six Months Continuation of Treatment, Follow-up Visit Within 7 Days After Mental Illness Hospital Stay, and Follow-up Visit Within 30 Days After Mental Illness Hospital Stay. The stars tell you how successful each health plan was at helping patients get the care they needed. More stars are better.

The scores show how well the health plan or medical group did at making sure women between the ages of 50 and 74 had a mammogram to screen for breast cancer during the past two years. The higher score means more women got the right care at the right time. The scores are based on information from at least 30 female health plan members' administrative records, medical group patient records,  or Medicare Advantage patient records in 2015.

The scores show how well the health plan did at making sure women receive appropriate cervical cancer screening according to national guidelines. The higher score means more women got the right care at the right time. The scores are based on information from administrative records of at least 30 female health plan members aged 21 to 64 in 2015. Some health plans also use patient medical records which are often more complete and result in higher scores. Plans that decide not to use medical records are likely to have lower scores.

The scores tell you how successful each medical group was at following national guidelines for screening women for cervical cancer. The score is based on the number of female patients who did not receive cervical cancer screening when it was not recommended and the number of female patients who appropriately received screening based on their age. This score differs from the cervical cancer screening measure reported for HMO and PPO health plans, which does not include women who should not get the test. Lower, less favorable scores are reported for this version of the measure than the one reported for health plans. The scores are based on information from at least 30 female medical group patient records in 2015.

Composite star rating calculation based on the health plan or medical groups's scores for Breast Cancer Screening, Cervical Cancer Screening, and Colorectal Cancer Screening. The stars tell you how successful each health plan or medical group was at helping patients get the care they needed. More stars are better.

The scores show how well each health plan did at making sure adolescents ages 12 to 17 had their BMI checked using their height and weight when they had a visit with their regular doctor during the past year. The higher score means more adolescents got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015. Some plans also use patient medical records which are often more complete and result in higher scores. Plans that decide not to use medical records are likely to have lower scores.

The scores show how well each health plan did at making sure children, ages 3 to 11, had their body mass index (BMI) checked using their height and weight, when they had a visit with their regular doctor during the past year. The higher score means more children got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015. Some plans also use patient medical records which are often more complete and result in higher scores. Plans that decide not to use medical records are likely to have lower scores.

The scores show how successful each health plan was at making sure that patients had their body mass index (BMI) checked using their height and weight, when they had a doctor visit during the past two years. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015. Some plans also use patient medical records which are often more complete and result in higher scores. Plans that decide not to use medical records are likely to have lower scores.

The scores show how successful each medical group was at making sure that patients ages 18-74 who had a doctor visit had their body mass index (BMI) checked during the past two years using their height and weight. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 Medicare Advantage patient records for each medical group in 2015.

The scores show how well each medical group did at making sure sexually active women, aged 16 through 24, were tested for Chlamydia. The higher score means more women got the right care at the right time. The scores are based on information from at least 30 medical group patient records in 2015.

The scores show how well each health plan did at making sure sexually active women aged 16 through 20 years were tested for Chlamydia. The higher score means more women got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015.

The scores show how well each health plan did at making sure sexually active women aged 21 to 24 were tested for Chlamydia. The higher score means more women got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015.

Composite star rating calculation based on the health plan's scores for Chlamydia Screening Age 16-20 and Chlamydia Screening Age 21-24. The stars tell you how successful each health plan was at helping patients get the care they needed. More stars are better.

Star rating calculation based on the medical group's score for Chlamydia Screening. The stars tell you how successful each medical group was at helping patients get the care they needed. More stars are better.

The scores show how well each health plan did at making sure patients, ages 50 to 75, were tested for colorectal cancer. The higher score means more patients got the right care at the right time. The scores are based on information from administrative records of at least 30 health plan members in 2015. Some plans also use patient medical records which are often more complete and result in higher scores. Plans that decide not to use medical records are likely to have lower scores.

The scores show how well each medical group did at making sure patients, ages 50 to 75, were tested for colorectal cancer. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 medical group or Medicare Advantage patient records for each medical group in 2015.

The scores show how well each health plan did at making sure patients with diabetes had blood pressure levels below 140/90, which indicates good control. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015. Some plans also use patient medical records which are often more complete and result in higher scores. Plans that decide not to use medical records are likely to have lower scores.

The scores show how well each medical group did at making sure patients with diabetes had blood pressure levels below 140/90, which indicates good control. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 medical group patient records in 2015.

The scores show how well each health plan did at making sure patients with diabetes had well-controlled blood sugar levels, which is an A1c level of less than 8%. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015. Some plans also use patient medical records which are often more complete and result in higher scores. Plans that decide not to use medical records are likely to have lower scores.

The scores show how well each medical group did at making sure patients ages 18-75 with type 1 or type 2 diabetes had well-controlled blood sugar levels, which is an A1c level of less than 9 percent for Medicare members. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 Medicare Advantage patient records for each medical group in 2015.

The higher score means more patients got the right care at the right time. The scores show how well each medical group did at making sure patients with diabetes had well-controlled blood sugar levels, which is an A1c level of less than 8%. The scores are based on information from at least 30 medical group patient records in 2015.

The scores show how well each health plan did at making sure patients with hypertension had their blood pressure below 140/90, or below 150/90 if you are 60 years or older, which indicates good control. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015. Some plans also use patient medical records which are often more complete and result in higher scores. Plans that decide not to use medical records are likely to have lower scores.

The scores show how well each medical group did at making sure patients with hypertension had their blood pressure below 140/90, or below 150/90 if you are 60 years or older, which indicates good control. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 medical group patient records in 2015.

The scores show the percentage of health plan members who reported that their doctor was up-to-date about the care they got from other doctors. The higher score means more members said their doctors worked together to coordinate their care The scores are based on information from a survey of a sample of at least 100 health plan members in 2015.

The scores show the percentage of health plan members who highly rated their HMO on its customer service. The higher score means more members said they are getting good customer service. The scores are based on information from a survey of a sample of at least 100 health plan members who contacted their plan in 2014 or 2015.

Composite star rating calculation based on the health plan's scores for Eye Exam for Diabetes Patients, Testing Blood Sugar for People with Diabetes, Controlling Blood Sugar for Diabetes Patients, Testing Kidney Function for Diabetes Patients, and Controlling Blood Pressure For Diabetes Patients. The stars tell you how successful each health plan was at helping patients get the care they needed. More stars are better.

Composite star rating calculation based on the medical group's scores for Testing Blood Sugar for People with Diabetes, Controlling Blood Sugar for People with Diabetes, Testing Kidney Function for People with Diabetes, and Controlling Blood Pressure For People with Diabetes. The stars tell you how successful each medical group was at helping patients get the care they needed. More stars are better.

The scores show how well each health plan did at making sure patients who smoke or quit recently received information from their doctor about ways to quit smoking. The higher score means more patients got the right care at the right time. The scores are based on information from a survey of a sample of at least 100 health plan members in 2015.

The scores show the percentage of health plan members who highly rated their doctors’ communication skills. The higher score means more patients said their doctors communicate well. The scores are based on information from a survey of a sample of at least 100 health plan members in 2015.

The scores show how well each health plan did at making sure patients with diabetes had an eye exam to check for damage that can lead to eye problems, like blindness. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015. Some plans also use patient medical records which are often more complete and result in higher scores. Plans that decide not to use medical records are likely to have lower scores.

The scores show how well each medical group did at making sure patients ages 18-75 with type 1 or type 2 diabetes had an eye exam to check for damage that can lead to eye problems, like blindness. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 Medicare Advantage patient records for each medical group in 2015.

The scores show how well each health plan did at making sure patients ages 18 to 64 years received a flu shot during the most recent flu season. The higher score means more patients got the right care at the right time. The scores are based on information from a survey of a sample of at least 100 health plan members in 2015.

The scores show how well each health plan did at making sure patients who were hospitalized for a mental illness were seen by a mental health provider within 30 days after leaving the hospital. The higher score means more patients got the right care at the right time.

The scores show how well each health plan did at making sure patients who were hospitalized for a mental illness were seen by a mental health provider within 7 days after leaving the hospital. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015.

The scores show the percentage of health plan members who highly rated their HMO on how quickly and easily they got care and service from their doctors and office staff. The higher score means more members said they are getting the right care at the right time. The scores are based on information from a survey of a sample of at least 100 health plan members in 2015.

Composite star rating calculation based on the health plan's scores for Getting Appointments and Care Quickly and Getting Doctors and Care Easily. The stars tell you how successful each HMO was at helping patients get the care they needed. More stars are better.

The scores show the percentage of health plan members who highly rated their HMO on getting the specialty care, tests, and treatment they needed, when they needed it. The higher score means more members said they are getting the right care at the right time. The scores are based on information from a survey of a sample of at least 100 health plan members in 2015.

The scores show how well each health plan or medical group did at making sure that patients who were prescribed medications long-term were tested to check that the ongoing use of the drug was not harming them. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records or medical group patient records in 2015.

The scores show the percentage of health plan members who highly rated their health care by giving the plan a score of 9 or 10 on a 0 to 10 scale. The higher score means more patients highly rated the health care they received. The scores are based on information from a survey of a sample of at least 100 health plan members in 2015.

The scores show how well each health plan did at receiving positive feedback from members that their doctor or other providers talked with them about how to stay healthy and prevent illness. The score means more patients said their doctors talked to them about how to make healthy lifestyle changes. The scores are based on information from a survey of a sample of at least 100 health plan members in 2015.

The scores show how well each health plan did at making sure patients who were hospitalized for a heart attack continued to receive beta blocker drugs for the six months following the heart attack. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015.

Composite star rating calculation based on the health plan's scores for Heart Attack Medication, Controlling High Blood Pressure, and Aspirin Use Counseling. The stars tell you how successful each health plan was at helping patients get the care they needed. More stars are better.

The scores show how well each medical group did at making sure that patients aged 65 and over were not prescribed high-risk medications. A higher score means more patients got the right care at the right time. The scores are based on information from at least 30 Medicare Advantage patient records for each medical group in 2015.

A summary rating based on more than 43 HEDIS® quality care measures sorted into 9 topics. The measures and topics are used to rate health plans on how well the plan and its doctors make sure that members get the right care for each health condition or topic and that they do not receive unnecessary care or services. Then, these health and topic ratings are combined to calculate the summary rating.

The scores show how well each health plan or medical group did at making sure pre-teen female patients received 3 shots of the HPV vaccine by their 13th birthday. The higher score means more pre-teen girls got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records or medical group patient records in 2015.

The scores show how well each medical group did at making sure preteen male patients received 3 shots of the HPV vaccine by their 13th birthday. The higher score means more preteen boys got the right care at the right time. The scores are based on information from at least 30 medical group patient records in 2015. The scores are generally low across all medical groups because the HPV vaccine for preteen boys is a new recommendation.

The scores show how well each health plan did at making sure all young children (age 2 years old) in the health plan received the vaccinations recommended by the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics. These vaccines include: measles, mumps, rubella, H influenza type B, chicken pox, diphtheria (an upper respiratory infection), tetanus, pertussis (whooping cough), polio; hepatitis B and pneumococcal vaccinations. The higher score means more children got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015. Some plans also use patient medical records which are often more complete and result in higher scores. Plans that decide not to use medical records are likely to have lower scores.

The scores show how well each medical group did at making sure all young children (age 2 years old) in the health plan received the vaccinations recommended by the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics. These vaccines include: measles, mumps, rubella, H influenza type B, chicken pox, diphtheria (an upper respiratory infection), tetanus, pertussis (whooping cough), polio; hepatitis B and pneumococcal vaccinations. The higher score means more children got the right care at the right time. The scores are based on information from at least 30 medical group patient records in 2015.

The scores show how well each health plan did at making sure adolescents in the health plan received meningococcal vaccine and a vaccine for tetanus, diphtheria (an upper respiratory infection), and pertussis (whooping cough) by age 13. The higher score means more adolescent children got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015. Some plans also use patient medical records which are often more complete and result in higher scores. Plans that decide not to use medical records are likely to have lower scores.

The scores show how well each medical group did at making sure young teen patients received a vaccine for tetanus, diphtheria (an upper respiratory infection), and pertussis (whooping cough)(Tdap) by age 13. The higher score means more adolescent children got the right care at the right time. The scores are based on information from at least 30 medical group patient records in 2015.

The scores show how well each medical group did at making sure that female patients age 67 to 85 who suffered a fracture were given a test to check the amount of calcium in their bones or a prescription for a drug to treat or prevent osteoporosis in the six months after the fracture. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 Medicare Advantage patient records for each medical group in 2015.

Composite star rating calculation based on the health plan's scores for Visits During Pregnancy and Visits After Giving Birth. The stars tell you how successful each health plan was at helping patients get the care they needed. More stars are better.

Participating medical groups who have commercial HMO health plan members are measured by the Integrated Healthcare Association (IHA) to determine if the medical care provided meets national standards for using treatments proven to be effective. This rating is a summary clinical rating developed from 5 different health topics or conditions. Each health topic is made from related quality measures. Twenty quality measures are reported; fifteen of the measures are combined into five health topics.

Participating medical groups who have Medicare HMO health plan members are measured by the Integrated Healthcare Association (IHA) to determine if the medical care provided meets national standards for using treatments proven to be effective.This rating is a summary clinical rating developed from 13 different health care quality measures. A medical group must have rates for at least seven of the quality measures to have the summary clinical quality rating. The scoring methodology to assign the star ratings for the summary rating uses the same cut-points that CMS uses to rate Medicare Advantage health plans. The overall rating is calculated by taking an average of the measure-level star ratings that are available for a medical group.

The scores show how well each medical group did at making sure that patients with diabetes age 18 and older who were given prescriptions for oral diabetes medications had their prescription filled for at least 80 percent of the days during the measurement period. This means that if the measurement period is 100 days, the medical group made sure that the diabetes prescription was filled for at least 80 days. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 Medicare Advantage patient records for each medical group in 2015.

The percentage of patients ages 18 and older and diagnosed with high blood pressure, who were given prescriptions for medicines called RAS Antagonists, had their prescription filled for at least 80 percent of the days during the measurement period. This means that if the measurement period is 100 days, the medical group made sure that the high blood pressure medication was filled for at least 80 days. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 Medicare Advantage patient records for each medical group in 2015.

The percentage of members age 18 and older who were given prescriptions for statin medication had their prescription filled for at least 80 percent of the days during the measurement period. This means that if the measurement period is 100 days, the medical group made sure that the statin medication was filled for at least 80 days. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 Medicare Advantage patient records for each medical group in 2015.

The scores show how well each health plan did at making sure children who were prescribed a medication for ADHD remained on medication for about 7 months and had at least 2 additional follow-up visits during the 9 months after their first month on medication and initial follow up visit. The higher score means more children got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015.

The scores show how well each health plan does at receiving feedback from members that their doctor talked with them about the pros and cons of their prescription medicine options and asked which choice best fit the patient’s needs. The higher score means more patients said their doctors shared decision making with them. The scores are based on information from a survey of a sample of at least 100 health plan members in 2015.

A summary rating based on the CAHPS® survey of health plan members. This survey asks members about their experience with the care and services offered by the health plan. Scores for the CAHPS® topics are based on the percentage of members who gave high scores or the most positive answers ("always" or "usually" for most questions) to the survey question. For most questions, answers are scored using one of four possible choices ranging from the member “always” had a positive experience to the member “never” had a positive experience.

The scores show the percentage of health plan members who highly rated their HMO on paying claims correctly and quickly. The higher score means more members said their claims are getting paid correctly and quickly. The scores are based on information from a survey of a sample of at least 100 health plan members who contacted their plan in 2014 and 2015.

The scores show how well each health plan did at making sure members can find cost information for a service or product. The higher score means more members said they are getting needed cost information. The scores are based on information from a survey of a sample of at least 100 health plan members who contacted their plan in 2014 or 2015. Plan results are reported here if 100 health plan members or more answered the survey. If fewer than 100 health plan members answered the survey, the plan results are only included in calculating the Satisfaction with Plan Services star rating.

The scores show how well each health plan did at making sure patients did not return to the hospital for the same or a different health condition within 30 days after a hospital visit. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015.

The scores show how well each medical group did at making sure patients did not return to the hospital for the same or a different health condition within 30 days after a hospital visit. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 medical group patient records in 2015.

The scores show how well each medical group did at making sure patients aged 65 and over did not return to the hospital for the same or a different health condition within 30 days after a hospital visit. Rates of readmission take into account how sick patients were when they went into the hospital the first time. This "risk-adjustment" helps make comparison between medical groups fair and meaningful. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 Medicare Advantage patient records for each medical group in 2015.

The scores show the percentage of health plan members who highly rated their plan by giving the plan a score of 9 or 10 on a 0 to 10 scale. The higher score means more patients highly rated their health plan. The scores are based on information from a survey of a sample of at least 100 health plan members in 2015.

The star ratings tell you how well members rated their experience with their doctors during 2015. The scores show the percentage of health plan members who gave the plan a score of 9 or 10 on a 0 to 10 scale. The scores are based on information from a survey of a sample of at least 100 health plan members in 2015.

The star ratings tell you how well members rated their experience with their specialists during 2015. The scores show the percentage of health plan members who gave the plan a score of 9 or 10 on a 0 to 10 scale. The scores are based on information from a survey of a sample of at least 100 health plan members in 2015.

Composite star rating calculation based on the health plan's scores for Rating of Doctor, Rating of Specialist, Health Care Highly Rated, Coordinated Care, and Health Promotion. The stars tell you how successful each HMO was at helping patients get the care they needed. More stars are better.

Composite star rating calculation based on the health plan's scores for Paying Claims, Rate Their HMO/PPO, Customer Service, and Plan Information on What You Pay. The stars tell you how successful each HMO was at helping patients get the care they needed. More stars are better.

The scores show how well each health plan did at making sure children who were prescribed a medication for ADHD had a follow-up visit within the first month after starting their medication. The higher score means more children got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015.

The scores show how well each medical group did at making sure patients with diabetes reached all four diabetes treatment goals. These diabetes treatment goals are controlling blood sugar, controlling blood pressure, testing for signs of kidney damage and testing blood sugar levels. The higher score means more patients got the right care at the right time.

The scores show how well each health plan did at making sure patients with diabetes had an A1c blood sugar test. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015. Some plans also use patient medical records which are often more complete and result in higher scores. Plans that decide not to use medical records are likely to have lower scores.

The scores show how well each medical group did at making sure patients with diabetes had at least two A1c blood sugar tests during the year. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 medical group patient records in 2015.

The scores show how well each health plan or medical group did at making sure patients with low back pain did not receive unnecessary imaging studies, according to recommended standards of care. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records or medical group patient records in 2015.

The scores show how well each health plan did at making sure patients with diabetes had their urine tested to watch for signs of kidney damage. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015. Some plans also use patient medical records which are often more complete and result in higher scores. Plans that decide not to use medical records are likely to have lower scores.

The scores show how well each medical group did at making sure Medicare Advantage patients ages 18-75 with type 1 or type 2 diabetes had their urine tested to watch for signs of kidney damage. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 Medicare Advantage patient records for each medical group in 2015.

The scores show how well each medical group did at making sure patients with diabetes had their urine tested to watch for signs of kidney damage. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 medical group patient records in 2015.

The scores show how well each health plan did at making sure patients, age 40 or older and newly diagnosed with Chronic Obstructive Pulmonary Disease, got a spirometry test to see how well their lungs take in and release air. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015.

Composite star rating calculation based on the health plan's scores for Checking if Weight Could Cause Health Problems, Flu Shots for Adults, Treating Arthritis With Medications, Giving Lab Tests for Patients Taking Medications for a Long Time, and Doctor Advises Patient to Quit Smoking. The stars tell you how successful each HMO was at helping patients get the care they needed. More stars are better.

The scores show how well each health plan or medical group did at making sure that patients who have rheumatoid arthritis, got a prescription for an anti-rheumatic drug. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records or Medicare Advantage patient records in 2015.

The scores show how well each health plan or medical group did at making sure patients who have acute bronchitis were not given an antibiotic — medicines that don’t work for these viral infections. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records or medical group patient records in 2015.

The scores show how well each health plan or medical group did at making sure children ages 2 to 18, who were diagnosed with a throat infection and given an antibiotic medication, were also tested for strep throat. The higher score means more children got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records or medical group patient records in 2015.

The scores show how well each health plan or medical group did at making sure children ages 3 months to 18 years, who had an upper respiratory infection (common cold) were not given an antibiotic, which does not work for these viral infections. The higher score means more children got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records or medical group patient records in 2015.

Composite star rating calculation based on the health plan's scores for Immunizations for Children, Immunizations for Early Teens, HPV Vaccine for Female Adolescents, Checking If Children's Weight Could Cause Health Problems, Checking if Adolescent’s Weight Could Cause Health Problems, Treating Children with Throat Infections, Treating Children with Upper Respiratory Infections, Starting Care for Attention Deficit Hyperactivity Disorder, and Ongoing Care for Attention Deficit Disorder. The stars tell you how successful each HMO was at helping patients get the care they needed. More stars are better.

Composite star rating calculation based on the medical group's scores for Immunizations for Children, Immunizations for Early Teens, HPV Vaccine for Female Adolescents, HPV Vaccine for Male Adolescents, Treating Children with Throat Infections, and Treating Children with Upper Respiratory Infections. The stars tell you how successful each medical group was at helping patients get the care they needed. More stars are better.

The scores show how well each health plan did at making sure patients with Chronic Obstructive Pulmonary Disease got the right medicine, called a bronchodilator, within 30 days after their breathing became even more difficult and resulted in an emergency room visit or hospital stay. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015.

The scores show how well each health plan did at making sure patients with Chronic Obstructive Pulmonary Disease got the right medicine, called a systemic corticosteroid, within 14 days after their breathing became even more difficult and resulted in an emergency room visit or hospital stay. The higher score means more patients got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015.

The scores show how well each health plan did at making sure that women had a check-up between 21-56 days after the birth of their baby. The higher score means more women got the right care at the right time. The scores are based on information from at least 30 health plan member administrative records in 2015. Some plans also use patient medical records which are often more complete and result in higher scores. Plans that decide not to use medical records are likely to have lower scores.

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