This article series is a monthly tool to help physicians maximize patient health outcomes in accordance with NCQA?s* HEDIS®† measurements for high quality care on important dimensions of services.
Go to our Highlighting HEDIS® page to view previously published Highlighting HEDIS® topics. If you have feedback or would like to request a topic, email us.
HEDIS® definition
Breast cancer screening: The percentage of women ages 50 – 74 who had a mammogram to screen for breast cancer.
Why this measure is important
This measure looks at whether female members are being screened for breast cancer. It assesses the percentage of women between ages 50 and 74 who had a mammogram to screen for breast cancer.
Breast cancer is the second most common type of cancer among American women, with approximately 178,000 new cases reported each year. It is most common in women older than 50. Women whose breast cancer is detected early have more treatment choices and better chances for survival. Mammography screening has been shown to reduce mortality by 20 ? 30 percent among women 40 and older. A mammogram can reveal tumors too small to be felt by hand; it can also show other changes in the breast that may suggest cancer.
? NCQA, HEDIS 2015 V1
National screening rates
The following chart shows the national average for commercial and Medicare breast cancer screening rates for HMO and PPO plans from 2005 ? 2013.
Source: 2014 State of Health Quality
Do you know your rates?
We are committed to keeping you informed. To learn more about your screening rates by provider office for AmeriHealth members, please email AmeriHealth.
Quick tips for improvement
- ✔ Develop a reminder system to help keep members up to date with screening.
- ✔ Educate members about the importance of breast cancer screening and provide educational resources such as the National Cancer Institute website.
- ✔ Provide members with information about screening procedures to help alleviate any anxiety or fear related to the screening.
Stars‡ alert
Breast cancer screening is a Medicare Stars measure.
*The National Committee for Quality Assurance (NCQA) is the most widely recognized accreditation program in the U.S. .
†The Healthcare Effectiveness Data and Information Set (HEDIS) is an NCQA tool used by more than 90 percent of U.S. health plans to measure performance on important dimensions of care.
‡Stars is a program developed by the Centers for Medicare & Medicaid Services to measure quality health care. Ratings are published annually to help educate consumers prior to enrollment decisions.
HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). Used with permission.