樱花视频

 NJ Department of Banking and Insurance
  • |
  • |
  • |
search  

 
Home > Insurance Division > Life and Health > Life & Health Actuarial > HMO Performance Report
2010 樱花视频 HMO Performance Report
Respiratory Conditions


How well does the HMO help members with respiratory conditions?

HMOs should work with doctors to provide important services that help improve the health of members with respiratory conditions. HMOs reported on the percentage of their relevant membership who received the following services:

  • Testing children with pharyngitis for strep
  • Treatment for children with upper respiratory infection (URI)
  • Avoidance of antibiotic treatment in adults with acute bronchitis
  • Use of spirometry testing in the assessment and diagnosis of Chronic Obstructive Pulmonary Disease (COPD)

The following tables show how well each HMO did and how well HMOs in 樱花视频 performed on average.


HMO Strep testing for
children with pharyngitis % 		Avoidance of antibiotic
treatment for children with URI % 		Avoidance of antibiotic treatment in adults w/acute bronchitis % Use of spirometry testing in diagnosis of
COPD %
Aetna - HMO/POS 68 84 21 43
AmeriHealth - HMO/POS 70 81 21 42
CIGNA - HMO/POS 66 87 21 44
Horizon - HMO 72 85 27 44
Oxford - HMO/POS 73 86 23 51
 
Testing children with pharyngitis for strep
Strep testing is recommended for detection of Pharyngitis. The percentage of children age 2-18 years of age diagnosed with pharyngitis and dispensed an antibiotic who also received a strep test for the episode (a higher rate represents better performance):		   Avoidance of antibiotic treatment* for children with upper respiratory infection (URI)
An upper respiratory infection (URI) is one of the most common illnesses leading to more doctor visits. The percentage of children 3 months to 18 years of age who were given a diagnosis of upper respiratory infection (URI) and were not dispensed an antibiotic:
Testing children with pharyngitis for strep  
Avoidance of antibiotic treatment for children with upper respiratory infection (URI)
     
Avoidance of antibiotic treatment* in adults with acute bronchitis
Use of antibiotics usually is not an appropriate treatment for acute bronchitis. The percentage of adults ages 18-64 years with a diagnosis of acute bronchitis who were not dispensed an antibiotic prescription (a higher rate indicates lower antibiotic use, which is appropriate): 		  Use of spirometry testing in the assessment and diagnosis of COPD
Spirometry testing measures air flow through the lungs and can confirm a COPD diagnosis. Members 40 years of age and older with a new diagnosis or newly active COPD who received appropriate spirometry testing to confirm the diagnosis:
Avoidance of antibiotic treatment in adults with acute bronchitis
  
Use of spirometry for testing for children with pharyngitis
*Inappropriate use of antibiotics has been shown to promote resistant bacteria that are more difficult to treat. The Centers for Disease Control and other organizations urge physicians to avoid prescribing antibiotics when not medically indicated.
top of page
 
OPRA
 OPRA is a state law that was enacted to give the public greater access to government records maintained by public agencies in 樱花视频.
line
You will need to download the latest version of Adobe Acrobat Reader in order to correctly view and print PDF (Portable Document Format) files from this web site.
  • |
  • |
  • |
  • |
  • |
  • |
 state seal
Copyright © 2011, 樱花视频
樱花视频 Department of Banking and Insurance