The effect of HEDIS measurement of colorectal cancer screening on insurance plans in Pennsylvania.
OBJECTIVE
To determine the effect of Healthcare Effectiveness Data and Information Set (HEDIS) measurement of colorectal cancer (CRC) screening on insurance plans in Pennsylvania.


METHODS
Natural experiment tracking changes in CRC screening policies.


METHODS
Survey data were collected in 2006 on screening policies of 13 Pennsylvania commercial insurers offering 37 plans. All companies that met the inclusion criteria were surveyed. Medical directors answered questions about how HEDIS measures affected plan benefit designs. Responses were analyzed using descriptive statistics.


RESULTS
All companies responded and focused their responses on a particular plan as requested, including 2 health maintenance organizations, 3 point-of-service plans, 2 fee-for-service plans, and 6 preferred provider organizations. The survey results indicated that 39% of plans revised their screening guidelines, 46% established new or updated reminder systems, and 46% established new systems for tracking screening rates. Although only the health maintenance organization plans were linked to HEDIS with formal reporting, all types of plans reported changes that they attributed to the HEDIS measure.


CONCLUSIONS
The establishment of the new HEDIS measure on screening for CRC has been associated with changes in health plan policies and practices in Pennsylvania.
Sarfaty
Mona
M
Department of Health Policy, Thomas Jefferson University, 1015 Walnut Ave, Curtis 115, Philadelphia, PA 19107, USA. mona.sarfaty@jefferson.edu
Myers
Ronald E
RE
D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000191:economics* / Q000517:prevention & control; D019983:Guideline Adherence; D006801:Humans; D007342:Insurance Benefits; D007348:Insurance, Health; D008403:Mass Screening / Q000191:economics*; D010414:Pennsylvania