Molinalogo

Measure

2024 Rate

2025 Rate

Goal

Prevention and Screening: This category shows how well our members stay up to date with important checkups, vaccines, and screenings that help detect health problems early — like flu shots, cancer screenings, and routine preventive tests.

Adult Immunization Status (AIS-E) - Influenza (Total)

33.65

36.46

52.39

Adult Immunization Status (AIS-E) - Pneumococcal (66+)

35.36

37.05

70.17

Adult Immunization Status (AIS-E) - Td/Tdap (Total)

30.04

30.05

44.31

Breast Cancer Screening (BCS-E)

55.77

58.48

79.14

Colorectal Cancer Screening (COL-E) -Total

59.65

<64.54

76.97

Respiratory: This category shows quality of care for conditions that affect breathing, such as a sore throat, asthma, or COPD. The measures show whether our members received the right tests and medicines when needed.

Appropriate Testing for Pharyngitis (CWP) -Total

57.58

81.63

70.83

Pharmacotherapy Management of COPD Exacerbation (PCE) - Bronchodilator

83.76

81.46

88.82

Pharmacotherapy Management of COPD Exacerbation (PCE) -Systemic Corticosteroid

76.64

67.98

78.88

Cardiovascular: This category reflects how well the plan helped our members manage heart‑related conditions. It includes measures about heart attack recovery, blood pressure control, and medicines that help protect the heart.

Cardiac Rehabilitation (CRE) - Initiation (Total)

2.03

1.44

7.20

Cardiac Rehabilitation (CRE) - Engagement1 (Total)

0.00

0.00

11.23

Cardiac Rehabilitation (CRE) - Engagement2 (Total)

0.00

0.00

10.76

Cardiac Rehabilitation (CRE) - Achievement (Total)

0.00

0.00

5.00

Controlling High Blood Pressure (CBP)

75.18

73.24

82.48

Persistence of Beta-Blocker Treatment After a Heart Attack (PBH)

72.73

64.71

77.42

Statin Therapy for Patients With Cardiovascular Disease (SPC) - Received Statin Therapy (Total)

86.22

82.30

83.55

Statin Therapy for Patients With Cardiovascular Disease (SPC) - Statin Adherence 80% (Total)

84.59

86.69

87.66

Diabetes: This category shows how well our members with diabetes are taking care of their health. The measures look at important tests, screenings, and treatments that help prevent complications — like eye exams, blood pressure control, and kidney checks.

Blood Pressure Control for Patients With Diabetes (BPD)

74.70

72.26

80.78

Eye Exam for Patients With Diabetes (EED)

55.72

62.29

83.21

Glycemic Status Assessment for Patients With Diabetes (GSD) - Glycemic Status <8.0%

69.59

73.48

79.05

Kidney Health Evaluation for Patients With Diabetes (KED) - Total

47.19

53.57

70.33

Statin Therapy for Patients With Diabetes (SPD) - Received Statin Therapy

75.79

76.76

83.55

Statin Therapy for Patients With Diabetes (SPD) - Statin Adherence 80%

85.63

87.07

87.66

Musculoskeletal Conditions: This category focuses on bone and joint health, especially for older adults. It includes measures related to screening for osteoporosis and making sure our members receive the right care after a fracture.

Osteoporosis Management in Women Who Had a Fracture (OMW)

20.63

25.42

58.06

Osteoporosis Screening in Older Women (OSW)

35.93

39.47

62.81

Behavioral Health: This category shows how well the plan supports our members with mental health or substance use conditions. They include follow‑up after hospital or emergency visits, and whether our members stay on important medications and continue to receive needed care.

Adherence to Antipsychotic Medications for Individuals With Schizophrenia (SAA)

83.77

86.53

85.37

Antidepressant Medication Management (AMM) - Effective Acute Phase Treatment

78.92

77.10

86.11

Antidepressant Medication Management (AMM) - Effective Continuation Phase Treatment

62.65

59.76

72.56

Follow-Up After Emergency Department Visit for Mental Illness (FUM) - 30 days (Total)

54.68

48.62

61.63

Follow-Up After Emergency Department Visit for Mental Illness (FUM) - 7 days (Total)

37.93

29.83

44.44

Follow-Up After Emergency Department Visit for Substance Use (FUA) - 30 days (Total)

57.53

50.50

47.79

Follow-Up After Emergency Department Visit for Substance Use (FUA) - 7 days (Total)

40.18

35.15

31.07

Follow-Up After High-Intensity Care for Substance Use Disorder (FUI) - 30 days (Total)

38.20

49.43

49.00

Follow-Up After High-Intensity Care for Substance Use Disorder (FUI) - 7 days (Total)

19.10

31.03

26.19

Follow-Up After Hospitalization for Mental Illness (FUH) - 30 days (Total)

46.61

58.59

62.38

Follow-Up After Hospitalization for Mental Illness (FUH) - 7 days (Total)

27.12

32.42

40.00

Pharmacotherapy for Opioid Use Disorder (POD) -Total

25.17

31.94

38.83

Care Coordination: This category reflects how well providers communicate and work together. It includes follow‑up after hospital visits, medication reviews, and making sure our members receive support after major health events.

Advance Care Planning (ACP)

54.14

61.93

67.98

Follow-Up After Emergency Department Visit for People With Multiple High-Risk Chronic Conditions (FMC) -Total

53.59

50.29

67.64

Transitions of Care (TRC) - Medication Reconciliation Post-Discharge (Total)

52.80

70.07

88.08

Transitions of Care (TRC) - Notification of Inpatient Admission (Total)

29.93

29.93

72.50

Transitions of Care (TRC) - Patient Engagement After Inpatient Discharge (Total)

77.62

84.43

91.97

Transitions of Care (TRC) - Receipt of Discharge Information (Total)

26.52

31.63

49.94

Appropriateness of Use: This category shows whether our members receive the right care — and avoid unnecessary or potentially harmful treatments. For example, these measures look at when antibiotics or imaging tests are used and whether they were truly needed.

Appropriate Treatment for Upper Respiratory Infection (URI) -Total

86.44

85.74

75.54

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

37.16

37.78

39.42

Use of Imaging Studies for Low Back Pain (LBP) - Total

71.95

73.46

57.14

Access and Availability of Care: This category shows how easily our members can get preventive care or treatment when they need it. It includes access to doctor visits and timely follow‑up for substance use treatment.

Adults' Access to Preventive/Ambulatory Health Services (AAP) - Total

92.83

93.78

97.45

Initiation and Engagement of Substance Use Disorder Treatment (IET) - Initiation of SUD Treatment - Total

68.22

66.08

45.13

Initiation and Engagement of Substance Use Disorder Treatment (IET) - Engagement of SUD Treatment - Total

7.34

5.45

7.90