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    Contact Us

    Texas Diabetes Program - Council
    MC 1965
    PO Box 149347 Austin, Texas 78714-9347
    1100 West 49th Street
    Austin, TX 78756

    Phone: (512) 458-7490
    Fax: (512) 458-7408

    Email comments or questions

Health Maintenance Organization (HMO) Recognition Program


Insurance In 2005, the Texas Diabetes Council implemented an HMO recognition program to encourage improvement in performance measures for diabetes care in Texas.

Acknowledging the impact HMOs have on quality of care for Texans with diabetes, the TDC invites organizations who surpass the state average for all HEDIS® measures relating to comprehensive diabetes care to be honored at a quarterly TDC meeting, and be recognized in Texas Diabetes the newsletter of the Texas Diabetes Council.

The TDC has recognized the following Texas HMOs for above average, comprehensive diabetes care based on performance charts presented in the Guide to Texas HMO Quality, for the following years:


  • Humana Health Plan of Texas (San Antonio/Corpus Christi and Austin markets)
  • Scott & White Health Plan
  • UnitedHealthcare/PacifiCare (San Antonio/Houston and Dallas/Austin markets)
  • Valley Baptist Health Plan


  • Community First Health Plans
  • HMO Blue Texas
  • Humana Health Plans of Texas (Austin & San Antonio markets)
  • PacifiCare of Texas (San Antonio/Houston & Dallas/Austin markets)
  • Scott and White Health Plan
  • UNICARE Health Plans
  • Valley Baptist Health Plan


  • FIRSTCARE (Lubbock market)
  • HMO Blue Texas
  • Humana Health Plans of Texas (Austin & San Antonio markets)
  • PacifiCare of Texas (San Antonio/Houston & Dallas/Austin markets)
  • Scott and White Health Plan
  • Valley Baptist Health Plan


  • Great-West Healthcare (Dallas)
  • HMO Blue Texas (Austin and Houston markets)
  • Humana Health Plan of San Antonio (San Antonio market)
  • PacifiCare of Texas (San Antonio)
  • Scott and White Health Plan
  • Valley Baptist Health Plan

*Reports for each year reflect the experience of Texans in HMOs for the previous year.

An above average ranking on all six performance measures relating to diabetes care suggests adherence to standards of care for type 1 and type 2 diabetes, a priority area of the TDC's strategic plan.

The Health Plan Employer Data and Information Set (HEDIS®) consists of standardized performance measures designed for comparing the quality of care of managed care organizations. This tool is used by more than 90 percent of America’s health plans to measure performance on important dimensions of care and service. Basic service HMOs in Texas with 5,000 or more members are required under Texas law to report HEDIS® measures annually to the Center for Health Statistics, Texas Department of State Health Services.

The HEDIS® performance measures for comprehensive diabetes care are listed with corresponding state and national averages below:

Percentage of members 18 through 75 years of age with type 1 or type 2 diabetes using the HMO who . . .
Texas Average 2008
National Average 2008*
had one or more HbA1c tests conducted within the past year
had their most recent HbA1c level greater than 9.0 percent during the past year**
had an eye screening for diabetic retinal disease within the past year, or negative retinal exam the year prior 
had a LDL-C test done within the last two years
hade a LDL-C test done with a level reading of less than 100 mg/dL during the last year



received medical attention for nephropathy or evidence of already having nephropathy within the past year



had their most recent blood pressure reading at less than 130 mm Hg systolic and 80 mm Hg diastolic during the past year

*National averages are presented as goals for the state.
**See Texas Diabetes Council A1c goals at http://www.tdctoolkit.org/algorithms_and_guidelines.asp. While higher percentages for other diabetes performance measures indicate improved performance, a lower percentage for this measure is favorable.

The Guide to Texas HMO Quality is published each year by the Texas Office of Public Insurance Counsel to aid health plan purchasers and consumers choose plans that best meet their needs.

Last updated July 23, 2013