Quality Benchmark measures will help ensure maintenance and improvement of healthcare quality and assess primary care, specialty and hospital provider, and public and private payer performance for the OHS Healthcare Benchmark Initiative.
The measures or quality benchmarks are recommended by members of the OHS HCBI Quality Council.
To view the Aligned and Core Measure Sets, click here.
Table 1a. Commercial Quality Benchmark Values Phase 1 (2022-2025)
Phase 1 Commercial Quality Benchmark Values
Asthma Medication Ratio (Ages 5-18)
2022 Value: 79%
2023 Value: 81%
2024 Value: 83%
2025 Value: 86%
Asthma Medication Ratio (Ages 19-64)
2022 Value: 78%
2023 Value: 80%
2024 Value: 82%
2025 Value: 85%
Controlling High Blood Pressure
2022 Value: 61%
2023 Value: 63%
2024 Value: 65%
2025 Value: 68%
Glycemic Status Assessment (formerly HbA1c Control) for Patients with Diabetes: HbA1c Poor Control1
2022 Value: 27%
2023 Value: 26%
2024 Value: N/A2
2025 Value: 23%
* A lower rate indicates better performance.
**Due to significant specification changes by the National Committee for Quality Assurance (NCQA) for measurement year (MY) 2024, this measure will be reporting only for MY 2024.
Table 1b. Commercial Quality Benchmark Measures Phase 2 (2022-2025)
Phase 2 Commercial Quality Benchmark Values
Child and Adolescent Well-Care Visits
2022 Value: N/A
2023 Value: N/A
2024 Value: 80%
2025 Value: 82%
Follow-up After ED Visit for Mental Illness (7-day)
2022 Value: N/A
2023 Value: N/A
2024 Value: 64%
2025 Value: N/A*
Follow-up After Hospitalization Visit for Mental Illness (7-day)
2022 Value: N/A
2023 Value: N/A
2024 Value: 67%
2025 Value N/A**
*Due to significant specification changes by the National Committee for Quality Assurance (NCQA) for measurement year (MY) 2025, this measure will be reporting only for MY 2025.
**Due to significant specification changes by the National Committee for Quality Assurance (NCQA) for measurement year (MY) 2025, this measure will be reporting only for MY 2025.
Table 2a. Medicaid Quality Benchmarks (2022-2025) Phase 1
Phase 1 Medicaid Quality Benchmark Measures
Asthma Medication Ratio (ages 5-18)
2022 Value: 66%
2023 Value: 68%
2024 Value: 70%
2025 Value: 73%
Asthma Medication Ratio (ages 19-64)
2022 Value: 63%
2023 Value: 65%
2024 Value: 67%
2025 Value: 70%
Controlling High Blood Pressure
2022 Value: 61%
2023 Value: 63%
2024 Value: 65%
2025 Value: 68%
Glycemic Status Assessment (formerly HbA1c Control) for Patients with Diabetes: HbA1c Poor Control*
2022 Value: 37%
2023 Value: 36%
2024 Value: N/A**
2025 Value: 33%
*A lower rate indicates better performance.
** Due to significant specification changes by the National Committee for Quality Assurance (NCQA) for measurement year (MY) 2024, this measure will be reporting only for MY 2024. OHS will reevaluate the 2025 Quality Benchmark value after performance is reported for MY 2024 with potential to adjust the MY 2025 Quality Benchmark value.
Table 2b. Medicaid Quality Benchmarks Phase 2 (2022-2025)
Phase 2 Medicaid Quality Benchmark Measures
Child and Adolescent Well-Care Visits2022 Value: N/A
2023 Value: N/A
2024 Value: 66%
2025 Value: 68%
Follow-up After ED Visit for Mental Illness (7-day)2022 Value: N/A
2023 Value: N/A
2024 Value: 60%
2025 Value: N/A*
Follow-up After Hospitalization Visit for Mental Illness (7-day)
2022 Value: N/A
2023 Value: N/A
2024 Value: 53%
2025 Value: N/A**
*Due to significant specification changes by the National Committee for Quality Assurance (NCQA) for measurement year (MY) 2025, this measure will be reporting only for MY 2025.
**Due to significant specification changes by the National Committee for Quality Assurance (NCQA) for measurement year (MY) 2025, this measure will be reporting only for MY 2025.
Table 3. Medicare Advantage Quality Benchmark Values Phase 1 (2022-2025)
Phase 1 Medicare Advantage Quality Benchmark Measures
Controlling High Blood Pressure
2022 Value: 73%
2023 Value: 75%
2024 Value: 77%
2025 Value: 80%
Glycemic Status Assessment (formerly HbA1c Control) for Patients with Diabetes: HbA1c Poor Control*
2022 Value: 20%
2023 Value: 18%
2024 Value: N/A
2025 Value: 15%**
*A lower rate indicates better performance.
**Due to significant specification changes by the National Committee for Quality Assurance (NCQA) for measurement year (MY) 2024, this measure will be reporting only for MY 2024. OHS will re-evaluate the 2025 Quality Benchmark value after performance is reported for MY 2024 with the potential to adjust the MY 2025 Quality Benchmark value.
Table 4. Statewide Quality Benchmark Values Phase 2 (2022-2025)
Phase 2 Statewide Quality Benchmark Values
Obesity Equity Measure**
2022 Value: N/A
2023 Value: N/A
2024 Value: 1.42
2025 Value: 1.38
**This measure is the ratio of statewide obesity rates for Black, non-Hispanic population and White, non-Hispanic population. A rate of 1 indicates that the statewide obesity rates for both populations are identical.
In addition to reporting statewide performance on the Obesity Equity Measure, OHS will also report the three-year rolling average obesity rate for the Black, non-Hispanic population against target values of 37% for 2024 and 35% for 2025.
Aligned Measure Sets
The aligned measure set is a set of measures from which OHS requests insurers select measures for use in new value-based contracts.
