HEDIS^® 2009 and CAHPS^® 2009 Results Reported in 2010

Hedis^® Audit

Molina Healthcare of New Mexico (MHNM) utilizes the NCQA (National Committee Quality Assurance) Health Effectiveness and Data Information Set (HEDIS®) as a measurement tool to provide a fair and consistent assessment of specific aspects of clinical care. The HEDIS® report is based on the care that MHNM’s Members received through the end of 2009.

Improvements were seen in many of MHNM’s 2009 HEDIS^® scores. Specific results can be viewed by clicking on the link below:

Three-Year Trending

• Improved performance on 30 of 50 measures from 2007 to 2009 (60%)
• Average improved of 3.31 percentage points from 2007 to 2009 - simple average for all reported measures

• Improved performance on 24 of 50 measures from 2008 to 2009 (48%)
• Average improvement of 3.698 percentage points from 2008 to 2009 -- simple average for all reported measures

• Exceeded 90^th percentile for 10 of 25 measures
• Exceeded 75^th percentile for 16 of 25 measures

• Exceeded 75^th percentile for 11 of 50 measures
• Of these, 6 exceeded the 90^th percentile
• Obtained or exceeded the Molina goal of the 75th percentile for 22% of reported measures.

MHNM's HEDIS® rates reflect the quality of care provided to Members. MHNM is very encouraged by the increases in cervical cancer screens and breast cancer screens. Cervical Cancer screens increased from 64.30% to 67.79% in 2010, while the breast cancer screening rate slightly increased from 50.58% to 50.78%.

Annual Dental Visits continues to show significant improvement from 59.83% in 2008 to 67.28% in 2009. For two years in a row this places MHNM above the 90th percentile for its combined dental rate when compared to NCQA’s national benchmarks from 2009.

MHNM is constantly seeking out opportunities for improvement, and we work with providers and Members to continually improve our Members’ health and increase the effectiveness of our healthcare systems. HEDIS® Rates for childhood immunizations and well child care exhibited significant decreases in 2010, and they are among the measures we are particularly focusing on in our current performance improvements. Among MHNM’s current interventions:

• A car seat program is provided for expectant mothers. As an encouragement for Members to obtain prenatal cares as early as possible, MHNM provides a convertible car seat upon completion of a qualifying maternity education class and a car seat safety class.
• Our Healthy Rewards Program gives an incentive gift card for completion of all scheduled immunizations for children from birth to two years.
• Our Healthy Rewards Program gives an incentive gift card for completion of all recommended well child exams from birth through the age of 6 years.
• Immunization schedules and well child care schedules are also included in postpartum packets. An additional immunization reminder is mailed out to parents through monthly reminder cards. Other targeted interventions, such as participation in shot clinics, are also provided for Members lacking immunizations.
• All identified diabetic and asthma Members receive age-specific educational materials. Molina’s disease management and health improvement programs work closely with these Members to identify their medical needs and concerns and work to improve their health. Reminder mailings are sent to providers and Members regarding important screenings that might have been missed.
• If a Member does not get an immunization or a well care exam, reminders are sent out to the Members parents/guardians encouraging them to get well-child check-ups and to get caught up on any missing immunizations.
• Preventive Care Guidelines are provided annually in our Member Newsletter, which is distributed quarterly.

CAHPS^® Survey

Molina Healthcare of New Mexico (MHNM) utilizes the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) as a measurement tool to provide a fair and consistent assessment of specific aspects of satisfaction with care. The CAHPS® survey is based on the care that MHNM’s Members received through the end of 2009. This survey looks at key satisfaction drivers throughout the continuum of care, including health plan performance and the Members' experiences in their physicians’ offices. The 2009 CAHPS® survey results show that MHNM’s Members are very satisfied with their overall care and health plan.

No CAHPS® score experienced a significant change from 2008 to 2009. MHNM will continue to focus on interventions that will affect both "Getting Needed Care" and "Customer Service". Our Quality Improvement Program and initiatives represent a collaborative effort between our contracted practitioners and MHNM to improve the overall health, quality of care and quality of service provided to all Members.

For more information on MHNM’s Quality Improvement Program, please call the Health Improvement Hotline at 1-(800)-377-9594 Ext. 182618. You can also view updated guidelines for several areas including preventive health, asthma, diabetes, hypertension, coronary artery disease, otitis media and URI/Pharyngitis in our Clinical Practice Guidelines section at: . For more information about HEDIS® Audits or CAHPS® Surveys, please call the MHNM Manager of Quality Analysis at 1-(800)-337-9594 Ext. 180288.

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