• The annual reported rate captures activity during the previous calendar year. 
• 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 include only Medicaid Primary beneficiaries in HEDIS administrative measures as of 2014.
• The red dashed trend line above is the 50th percentile national benchmark for Medicaid programs. The solid blue trend line is Vermont Medicaid's actual values.

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: July 2019

Author: DVHA Quality Unit

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 and Managed Care Medical 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 PMR staff. The team circulated a banner release related to medical record transfers (an activity that can increase the wait time for appointment scheduling) and will wrap up with an Advisory article on this topic in July.