The changes included members of between ages 5 to 64. The members identified are those who were considered as to have consistent asthma, and having remained on appropriate medications for asthma during the treatment period (Stanford, Shah, D’Souza & Schatz, 2013). The two rates that were reported included members that remained on asthma controller for a period of at least fifty percent during treatment, and also those who remained for a period of about 75% during their treatment. The ages were divided between 5 to 11, 12 to 18, 19 to 50, and 51 to sixty-four. The product lines included both commercial and Medicaid. The ASM denominator required on to identify persistent asthma and dispense asthma medication in four events (HEDIS/CAPHS REPORT, 2013). Some conditions like COPD, emphysema, acute respiratory failure and cystic fibrosis were excluded in the diagnosis. The ASM numerator required that one dispensed a prescription for the preferred therapy during the treatment year (Kanter,Gail, Jim&Alide, 2013).

The health insurance company chosen is Aetna Health, Inc. (Florida). The company is a commercial type, with HMO/ POS combined. It has more that 279201 members. It serves members from the state of Florida. The plan is accredited, even when measures from HEDIS and CAHPS are included. The expiry date of the accreditation is 05/09/2015, and it is scheduled for healthy,getting better and living with illness (NCQA, 2014).

References

HEDIS/CAPHS REPORT. (2013). Comparative analysis of audited results from TennCare MCOs. Retrieved from http://www.tn.gov/tenncare/forms/hedis13.pdf

Kanter, M.H., Gail, L., Jim, B., &Alide, C. (2013). Complete care and Kaiser Permanente: Transforming chronic and preventive care. Joint Commission Journal on Quality and Patient Safety, 39(11), 484-494.

NCQA.(2014). Health plan reports card. Retrieved from http://reportcard.ncqa.org/plan/external/PlanList.aspx?name=&state=FL&zipcode=-1&plantype=&statename=Florida

Stanford, H.R., Shah, B.M., D’Souza, A.O., & Schatz, M. (2013).Predicting asthma outcomes in commercially insured and Medicaid populations.American Journal of Managed Care. 19(1), 60-67.