• The annual reported rate captures activity during the previous calendar year.  For example, the 2017 rate captures services provided during calendar year 2016.
• This is a Healthcare Effectiveness & Data Information Set (HEDIS) administrative measure.
• Based on the advice of their External Quality Review Organization (EQRO), DVHA’s rates only include only Medicaid Primary beneficiaries in HEDIS administrative measures as of 2014.
• The target trend line is the 50th percentile national benchmark for Medicaid programs.

This measure looks at whether adult members receive preventive and ambulatory services. It looks at the percentage of Vermont adults with Medicaid who have had a preventative or ambulatory visit to their physician. Consider the other side of this measure: How many patients never access the system? If they never access the healthcare system, how does preventive care and counseling (diet, exercise, smoking cessation, seat belt use, etc.) occur? This measure is an indicator as to whether there may be barriers to our beneficiaries accessing preventive care.

Last updated: August 2017

Author: DVHA Quality Unit