Blue Cross and Blue Shield of New Mexico
www.bcbsnm.com | Commercial, HMO
- #200
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in Commercial Health Plans
Rank and score of 0 to 100 indicate satisfaction of surveyed members and success relative to other commercial plans in preventing and treating illness.
Available in: New Mexico
| Overall Score: | 79.0 |
| Satisfaction: |  |
| Prevention: | |
| Treatment: | |
| NCQA Accredition: | Yes |
How This Plan Performed (methodology)
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Treatment
Treating chronic and acute conditions.
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| Asthma |  |
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Medicate appropriately (5-9 years old)
Appropriate drugs prescribed for asthmatic children ages 5 to 9.
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Medicate appropriately (10-17 years old)
Appropriate drugs prescribed for asthmatic children ages 10 to 17.
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Medicate appropriately (18-56 years old)
Appropriate drugs prescribed for asthmatic adults.
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| Diabetes |  |
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Blood pressure control (130/80)
Diabetic members up to age 75 with blood pressure below 130/80 at last visit.
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Blood pressure control (140/90)
Diabetic members up to age 75 with blood pressure below 140/90 at last visit.
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Retinal eye exams
Eye exam given to diabetic members to age 75.
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Glucose testing
Blood sugar level checked in diabetic members to age 75.
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Glucose control
Blood sugar level maintained at 9 percent or below in diabetic members to age 75.
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LDL cholesterol screening
Cholesterol checked in diabetic members to age 75.
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LDL cholesterol control
Cholesterol below 100 milligrams per deciliter maintained in diabetic members to age 75.
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Monitoring kidney disease
Kidney function checked in diabetic members to age 75.
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| Heart disease | |
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Beta blocker after heart attack
Treated heart-attack patients ages 35 or older with beta blocker for at least six months.
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NA |
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Controlling high blood pressure
Blood pressure below 140/90 at last visit in hypertensive adults to age 85.
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LDL cholesterol screening
Cholesterol checked in members with heart disease.
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LDL cholesterol control
Cholesterol level below 100 milligrams per deciliter maintained in adults with heart disease.
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| Mental and behavioral health | |
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Depression--adhering to medication for 12 weeks
Newly diagnosed adults took prescribed drug for 12 weeks.
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Depression--adhering to medication for six months
Newly diagnosed adults took prescribed drug for at least six months.
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Follow-up after hospitalization for mental illness
Members ages 6 and up followed up within a week and again within a month of discharge from a hospital.
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Alcohol or drug dependence treatment initiated
Alcohol- or drug-dependent members ages 13 and above received inpatient or outpatient care.
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Alcohol or drug dependence treated for 30 days
Alcohol- or drug-dependent members ages 13 and above received two or more services within 30 days after initial treatment.
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Follow-up after ADHD diagnosis
Children ages 6 to 12 newly diagnosed with attention deficit hyperactivity disorder were prescribed drugs and saw practitioner within 30 days.
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Continued follow-up after ADHD diagnosis
Children ages 6 to 12 newly diagnosed with ADHD were treated for seven months and had three follow-up visits within nine months.
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NA |
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Appropriate antibiotic use, adults with acute bronchitis
Antibiotic not immediately prescribed for adults diagnosed with acute bronchitis.
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Appropriate testing and care, children with pharyngitis
Antibiotic and strep test prescribed for children diagnosed with sore throat.
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Medication for rheumatoid arthritis
Adults newly diagnosed with rheumatoid arthritis got appropriate drug.
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Monitoring key long-term medications
Adults with six-month prescriptions for certain drugs were clinically monitored.
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Steroid after hospitalization for acute COPD
Adults ages 40 and above received systemic corticosteroid within 14 days of diagnosis of chronic obstructive pulmonary disease following hospitalization.
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NA |
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Bronchodilator after hospitalization for acute COPD
Adults ages 40 and above diagnosed with chronic obstructive pulmonary disease given bronchodialator medication within 30 days of hospital discharge.
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NA |
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Testing for COPD
Adults ages 40 and above had spirometry test to confirm chronic obstructive pulmonary disease.
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Appropriate antibiotic use, children with URI
Antibiotic not immediately prescribed for children diagnosed with common cold.
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