November 2009
Cholesterol screening HEDIS 2009: How do we compare?
Regence supports members' efforts to improve their cholesterol levels through our disease management program, health coaching, and self-help programs and articles available on myRegence.com.
Please review the cholesterol management clinical practice guidelines and encourage your patients to contact Customer Service to confirm their benefits and assist them with identifying resources we have to help them with their cholesterol management.
How do Regence BlueCross BlueShield of Oregon (Regence BCBSO) cholesterol screening rates compare to the national average and 90th percentile performance? Data tables included below provide a summary of our recent performance.
The Health Effectiveness Data and Information Set (HEDIS) rates are based on claims data submitted by our participating providers. As a reminder, the following CPT codes are used to identify a low-density lipoprotein cholesterol (LDL-C) screening:
- CPT (Category I) 80061, 83700, 83704, 83721
- CPT (Category II) 3048F and 3050F
Summary Data Tables
Measure: The percentage of Preferred Provider Organization (PPO) members 18-75 years of age who experienced one of the following:
- Had an LDL-C screening during the measurement year
- Had a diagnosis of ischemic vascular disease (IVD) during the measurement year and the year prior to the measurement year
- Were discharged for acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous transluminal coronary angioplasty from January 1 to November 1 of the year prior to the measurement year
Regence BCBSO rates for commercial and Medicare Advantage PPO populations are above the national average but below the 90th percentile.
A 10% decrease in total cholesterol levels in the U.S. population could result in an estimated 30% reduction in coronary heart disease incidence.
Commercial PPO HEDIS Results (percentages rounded to the nearest whole number)
Regence Plan Name |
Regence |
Regence |
NCQA 2007 National Average |
NCQA 2007 National 90th Percentile |
Regional Performance Relative to National Average |
Regence BlueShield of Idaho |
64% |
71% |
74% |
84% |
73% Mountain |
Regence BlueCross BlueShield of Oregon (Regence BCBSO) |
77% |
84% |
74% |
84% |
74% Pacific |
Regence BlueCross BlueShield of Utah (Regence BCBSU) |
72% |
68% |
74% |
84% |
73% Mountain |
Regence BlueShield (select counties in Washington) |
77% |
77% |
74% |
84% |
74% Pacific |
* Measurement year
Medicare Advantage PPO HEDIS Results (percentages rounded to the nearest whole number)
Regence Plan Name |
Regence |
Regence |
NCQA 2007 National Average |
NCQA 2007 National 90th Percentile |
Regional Performance Relative to National Average |
Regence BlueShield of Idaho |
90% |
84% |
84% |
92% |
83% Mountain |
Regence BCBSO |
86% |
90% |
84% |
92% |
84% Pacific |
Regence BCBSU |
69% |
65% |
84% |
92% |
83% Mountain |
Regence BlueShield (select counties in Washington) |
89% |
87% |
84% |
92% |
84% Pacific |
* Measurement year