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Measure / Data Element |
2019 |
2020 |
2020 Goal |
Adult BMI Assessment (ABA) |
85.64% |
87.59% |
92.21% |
Annual Dental Visit (ADV) |
NB |
BR |
46.66% |
Antidepressant Medication Management (AMM) Effective Acute Phase Treatment |
56.54% |
60.44% |
77.07% |
Antidepressant Medication Management (AMM) Effective Continuation Phase Treatment |
45.01% |
41.77% |
58.81% |
Appropriate Testing for Pharyngitis (CWP) |
41.67% |
30.40% |
92.25% |
Appropriate Treatment for Upper Respiratory Infection (URI) |
88.46% |
76.02% |
95.04% |
Avoidance of Antibiotic Treatment for Acute Bronchitis / Bronchiolitis (AAB) |
34.22% |
33.17% |
38.65% |
Breast Cancer Screening (BCS) |
47.38% |
48.00% |
73.20% |
Cervical Cancer Screening (CCS) |
42.34% |
42.34% |
65.17% |
Childhood Immunization Status (CIS) Combination #3 Total |
NA |
74.29% |
81.08% |
Chlamydia Screening in Women (CHL) Total |
51.64% |
55.79% |
55.43% |
Colorectal Cancer Screening (COL) |
27.25% |
31.39% |
63.04% |
Comprehensive Diabetes Care (CDC) Eye Exam (Retinal) Performed |
51.34% |
55.96% |
56.11% |
Comprehensive Diabetes Care (CDC) HbA1c Control (<8.0%) |
58.15% |
54.01% |
63.75% |
Comprehensive Diabetes Care (CDC) Monitoring for Nephropathy |
90.02% |
94.40% |
92.70% |
Controlling High Blood Pressure (CBP) |
58.39% |
65.45% |
69.83% |
Follow-Up After Hospitalization for Mental Illness (FUH) 7-Day Rate Total |
NA |
NA |
47.83% |
Immunizations for Adolescents (IMA) Combination #2 Total |
25.81% |
40.43% |
26.75% |
Initiation and Engagement of Alcohol and Other Drug Dependence Treatment (IET) Initiation of AOD Treatment Rate Total |
28.64% |
20.61% |
38.98% |
Initiation and Engagement of Alcohol and Other Drug Dependence Treatment (IET) Engagement of AOD Treatment Rate Total |
5.97% |
2.83% |
14.62% |
Medication Management for People with Asthma (MMA) Total Medication Compliance 75% Rate only |
38.24% |
28.74% |
62.00% |
Plan All-Cause Readmission (PCR) |
93.10% |
95.05% |
≤ 63.85% |
Prenatal and Postpartum Care (PPC) Timeliness of Prenatal Care |
73.17% |
86.16% |
91.14% |
Prenatal and Postpartum Care (PPC) Postpartum Care |
58.54% |
72.96% |
82.14% |
Proportion of Days Covered (PDC) RAS Antagonists |
65.34% |
65.25% |
81.71% |
Proportion of Days Covered (PDC) Diabetes All Class |
56.95% |
61.09% |
77.54% |
Proportion of Days Covered (PDC) Statins |
51.10% |
56.32% |
78.63% |
Use of Imaging Studies for Low Back Pain (LBP) |
71.67% |
73.39% |
81.31% |
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC) BMI Screening Total |
74.45% |
76.16% |
88.68% |
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC) Counseling for Nutrition |
67.64% |
67.15% |
82.77% |
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/ Adolescents (WCC) Counseling on Physical Activity Total |
63.99% |
67.40% |
79.47% |
Well-Child Visits in the First 15 Months of Life (W15) 6 or More Visits Total |
NA |
NA |
83.05% |
Well-Child Visits in the Third, Fourth, Fifth, and Sixth Years of Life (W34) |
57.98% |
66.52% |
84.16% |
Molina Healthcare of California Overall Marketplace Quality Rating = 2 Stars.
CMS rates qualified health plans (QHPs) offered through the Exchanges using the Quality Rating System (QRS), which is based on third-party validated clinical measure data and QHP Enrollee Survey response data. CMS calculates QRS ratings annually using a 5-star scale. QHP issuers contract with HHS-approved survey vendors that independently conduct the QHP Enrollee Survey each year. QRS ratings and QHP Enrollee Survey results may change from one year to the next. For more information, please see CMS’ Health Insurance MarketplaceSM Quality Initiatives website at: CMS.gov.
NA = Not Available Due to Small Denominator
NB = No Benefit
NR = Not Reported
NQ = Not Required
BR = Biased Rate
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