HEDIS® Results

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HEDIS® Results

Marketplace HEDIS® Annual Rates.

Molina’s scores for the past two years are below. You can see how Molina performs compared to our target goal.

Measure/Data Element

2019

2020

2020 Goal

Adult BMI Assessment (ABA)

69.34%

94.07%

92.21%

Annual Dental Visit (ADV)

NB

NB

46.66%

Antidepressant Medication Management (AMM) Effective Acute Phase Treatment

63.26%

58.91%

77.07%

Antidepressant Medication Management (AMM) Effective Continuation Phase Treatment

47.45%

43.41%

58.81%

Appropriate Testing for Pharyngitis (CWP)

75.70%

42.01%

92.25%

Appropriate Treatment for Upper Respiratory Infection (URI)

92.18%

64.63%

95.04%

Avoidance of Antibiotic Treatment for Acute Bronchitis / Bronchiolitis (AAB)

40.07%

42.00%

38.65%

Breast Cancer Screening (BCS)

54.01%

56.01%

73.20%

Cervical Cancer Screening (CCS)

47.20%

46.96%

65.17%

Childhood Immunization Status (CIS) Combination #3 Total

75.81%

81.82%

81.08%

Chlamydia Screening in Women (CHL) Total

61.23%

62.33%

55.43%

Colorectal Cancer Screening (COL)

26.84%

34.31%

63.04%

Comprehensive Diabetes Care (CDC) Eye Exam (Retinal) Performed

22.01%

31.63%

56.11%

Comprehensive Diabetes Care (CDC) HbA1c Control (<8.0%)

48.86%

55.23%

63.75%

Comprehensive Diabetes Care (CDC) Monitoring for Nephropathy

89.47%

94.16%

92.70%

Controlling High Blood Pressure (CBP)

34.34%

62.29%

69.83%

Follow-Up After Hospitalization for Mental Illness (FUH) 7-Day Rate Only

25.71%

25.93%

47.83%

Immunizations for Adolescents (IMA) Combination #2 Total

24.32%

30.56%

26.75%

Initiation and Engagement of Alcohol and Other Drug Dependence Treatment (IET) Initiation of AOD Treatment Rate Total

29.80%

28.21%

38.98%

Initiation and Engagement of Alcohol and Other Drug Dependence Treatment (IET) Engagement of AOD Treatment Rate Total

3.14%

4.73%

14.62%

Medication Management for People with Asthma (MMA) Medication Compliance 75% Rate Only

43.37%

42.37%

62.00%

Plan All-Cause Readmission (PCR)

89.04%

94.83%

≤ 63.85%

Prenatal and Postpartum Care (PPC) Timeliness of Prenatal Care

64.38%

86.56%

91.14%

Prenatal and Postpartum Care (PPC) Postpartum Care

41.92%

67.20%

82.14%

Proportion of Days Covered (PDC) RAS Antagonists

62.79%

57.89%

81.71%

Proportion of Days Covered (PDC) Diabetes All Class

55.21%

54.52%

77.54%

Proportion of Days Covered (PDC) Statins

49.06%

50.16%

78.63%

Use of Imaging Studies for Low Back Pain (LBP)

64.91%

75.57%

81.31%

Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (WCC) BMI Screening Total

71.44%

89.78%

88.68%

Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (WCC) Counseling for Nutrition Total

69.07%

81.27%

82.77%

Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (WCC) Counseling for Physical Activity Total

50.74%

78.59%

79.47%

Well-Child Visits in the First 15 Months of Life (W15) 6 or More Visits Total

72.73%

86.05%

83.05%

Well-Child Visits in the Third, Fourth, Fifth, and Sixth Years of Life (W34)

85.03%

81.31%

84.16%

Molina Healthcare of Florida 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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