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Louisiana Department of Health & Hospitals | Kathy Kliebert, Secretary

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Statewide Initiatives



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Louisiana HEDIS® Measures

When initially developed over 20 years ago by the National Committee for Quality Assurance (NCQA), HEDIS® measures were intended to provide a tool and common metrics for employers to use when selecting from competing health plans for their employees' health care benefits. During the intervening period, the measures have evolved and are now widely used by consumers, purchasers, public programs and others to assess and compare physician and health plan performance. Originally, HEDIS® was the acronym for Health Plan and Employer Data and Information Set, but now is the Healthcare Effectiveness Data and Information Set to reflect its broader scope and utility.

For the past eight years, the Louisiana Medicaid program has calculated HEDIS® measures using paid claims data. Beginning initially with diabetes measures, today 18 measures are calculated annually. Because of the time needed for claims to be submitted, processed and paid, there is a lag between the measurement year and the calculation of measures. HEDIS® measures are intended to be calculated annually by calendar year.

HEDIS® Measures for Louisiana Medicaid

Adolescent Well-Care Visits: Measures the number of adolescents 12-21 years of age who were continuously enrolled in Louisiana Medicaid during the measurement year, and who had at least one comprehensive well-care visit during the measurement year. See measures.

Breast Cancer Screening: Measures the number of women 40-69 years of age who were enrolled in Louisiana Medicaid during the measurement year and the year prior to the measurement year, who had a mammogram during the measurement year or the year prior to the measurement year. See measures.

Cervical Cancer Screening: Measures the number of women 24-64 years of age who were continuously enrolled in Louisiana Medicaid during the measurement year, and who had one or more Pap tests for cervical cancer screening during the measurement year or the two years prior to the measurement year. See measures.

Childhood Immunization Status: Measures the number of children who turned 2 years old during the measurement year and who were continuously enrolled in Louisiana Medicaid during the measurement year, and who received Combination 2 or Combination 3 immunizations by their second birthdays. See measures.

Children and Adolescents' Access to Primary Care Practitioners: Measures the number of children and adolescents 12-24 months of age, 2-6, 7-11, or 12-19 years of age, who were continuously enrolled in Louisiana Medicaid during the measurement year and who had at least one ambulatory or preventive care visit during the measurement year. See measures for infants, children, adolescents and teens.

Cholesterol Management for Patients with Cardiovascular Conditions: Measures the number of people with cardiovascular conditions, 18-75 years of age as of December 31 of the measurement year, who were continuously enrolled in Louisiana Medicaid during the measurement year and the year prior to the measurement year, who had a screening during the measurement year. See measures.

Comprehensive Diabetes Care: Measures the number of people 18-75 years of age with either Type 1 or Type 2 diabetes, who were continuously enrolled in Louisiana Medicaid for the measurement year and who had one or more of the respective tests or met other measurement criteria during the measurement year. See measures.

Lead Screening in Children: Measures the number of children 0-2 years of age who were continuously enrolled in Louisiana Medicaid during the measurement year, and who had one or more capillary or venous lead blood tests for lead poisoning by their second birthday. See measures.

Use of Appropriate Medications for People with Asthma: Measures the number of people 5-50 years of age in 2009 and 2010, and the number of people 5-64 years of age in 2011 with persistent asthma, who were continuously enrolled in Louisiana Medicaid during the measurement year, and were prescribed medications preferred for long-term asthma control. See measures.

Well-Child Visits in the First 15 Months of Life:Measures the number of children who turned 15 months old during the measurement year, who were continuously enrolled in Louisiana Medicaid between one and 15 months of age, and who had from 0 to 6+ well-child visits during their first 15 months of life. See measures.

Well-Child Visits in the Third, Fourth, Fifth, and Sixth Years of Life: Measures the number of children 3-6 years of age, who were continuously enrolled in Louisiana Medicaid during the measurement year, and who had at least one well-child visit during the measurement year. See measures.

Annual Dental Visits: Measures the number of people 2-3, 4-6, 7-10, 11-14, 15-18, or 19-21 years of age, and the combined total, who were continuously enrolled in Louisiana Medicaid, and who had at least one dental visit during the measurement year. See measures.

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