Vermont Medicaid (Global Commitment) (GC-21)

AAP: Adults' Access to Preventive/Ambulatory Health Services (GC-21)


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Notes on Methodology
  • The target trendline in the graph above represents an accepted national benchmark percentile for Medicaid programs across the country. The value graphed historically was the national 50th percentile for comparison purposes. In 2020 (for measurement year 2019) we modified the value shown to demonstrate a target based on our actual performance.  For this measure, the target is the 75th national percentile.
  • The annual reported rate captures activity during the previous calendar year. 
  • This is a Healthcare Effectiveness & Data Information Set (HEDIS) administrative measure.
  • DVHA’s rates only include Medicaid Primary beneficiaries in HEDIS administrative measures.
Story Behind the Curve

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. The drop in our rate in 2021 (for measurement year 2020) is likely attributable to the COVID-19 pandemic.

Last updated: September 2021

Action Plan

Although DVHA performs well on this measure, we noticed in 2017 that our rates were below the 50th percentile national benchmark for 3 consecutive years. The DVHA Quality Committee recommended that we convene a Quality Improvement work group to explore this measure further. The project team included DVHA Quality Unit, Clinical, Data, VCCI and Provider & Member Relations staff. The team circulated a banner release and a Medicaid provider newsletter article related to medical record transfers (an activity that can increase the wait time for appointment scheduling). 

Scorecard Result Container Indicator Measure Action Actual Value Target Value Tag S R I P PM A m/d/yy m/d/yyyy