A personalized preventive care model versus a traditional practice: comparison of HEDIS measures

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Ralph E Seligmann
Lawrence P. Gassner
Ned D. Stolzberg
Nisal K. Samarasekera
Kimberly Warth
Andrea Klemes

Abstract

Objective:  The objective of the study was to assess the impact of the MDVIP primary care model that focuses on personalized preventive healthcare and to compare the rates of HEDIS effectiveness of care measures from the MDVIP model to national health plan results.Methods:  We performed a retrospective chart review of 15 MDVIP-affiliated Arizona physicians and used descriptive statistics (percentages) to compare the average rates of each of the HEDIS measures from our chart review to the 2010 national health maintenance organization (HMO) and preferred provider organization (PPO) health plans average rates published by the National Committee for Quality Assurance (NCQA). Results:  357 members (41.5% men, 70.9% age > 65 years) identified as having a diagnosis of uncomplicated diabetes, hyperlipidemia, hypertension or atrial fibrillation were included.  A higher percentage of MDVIP members with Diabetes Mellitus had good blood pressure control (<140/90), LDL-C levels <100 and eye exam rates as compared with the national health plan rates.  The majority (>93%) of MDVIP members had “good” HbA1c (<8%) control, which was much higher than the national HMO (~64%) and PPO (~55%) plan reported rates.  A higher percentage of MDVIP members with cardiovascular conditions had LDL-C screenings (~96%) performed compared with national HMO (89%) and PPO (~84%) plan rates.  A higher percentage of MDVIP members had mammograms (87%) and colonoscopies (85%) performed as compared with national HMO and PPO plan rates.    Conclusions:  These results support our belief that the MDVIP primary care model delivers better preventive care services when compared to national health plans.

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Regular Articles

References

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