HEDIS® 2010 for California
Molina values the care and service, health education and advice our providers give to our members. Our HEDIS® (Healthcare Effectiveness Data and Information Set) and quality improvement programs and initiatives represent a collaborative effort between our providers and Molina to improve overall healthcare. Together, we can make a difference in our member's health outcomes.
Molina Healthcare of California participates in annual HEDIS® (Healthcare Effectiveness Data and Information Set) data collection that is used for California MediCal and Healthy Families quality reporting and voluntary NCQA (National Committee for Quality Assurance) accreditation process. The 2010 HEDIS® scores are based on the care members received through the end of 2009. Molina's goal for all HEDIS® rates is to reach the 90th percentile performance for quality of care based on NCQA national Medicaid benchmarks.
2010 HEDIS scores for each service area are posted below:
Measures of care that met the NCQA 75th or 90th percentile for each product line included:
San Bernardino/Riverside Medicaid HEDIS results
- Well Child Care: First 15 months of care, 4 and 5 visits (75th percentile)
- Well Child Care: Years 3 to 6 (75th percentile)
- Comprehensive Diabetes Care: HbA1c Control and HbA1c Poor Control (90th percentile)
- Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis (90th percentile)
Riverside/San Bernardino HEDIS® measures with improvement included: Well Child Care First 15 months of care for six or more visits, Breast Cancer Screening, Chlamydia Screening in Women, HbA1c testing and LDL-C Screening for diabetics, Children’s Access to Primary Care, and Adult Access to Preventive Care.
Sacramento Medicaid HEDIS results
- Well Child Care: First 15 months of care for 2, 3,4 and 5 visits (75th percentile)
- Well Child Care: Years 3 to 6 (75th percentile)
- URI Treatment (75th percentile)
- Chlamydia Screening in Women (75th percentile)
- Comprehensive Diabetes Care: HbA1c Poor Control (90th percentile)
- Cholesterol Management: LDL <100 (75th percentile)
- Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis (75th percentile)
- Use of Imagine for Low Back Pain (90th percentile)
Sacramento HEDIS® measures with improvement included: Well Child Care First 15 months of care for six or more visits, Breast Cancer Screening, Timeliness of Prenatal Care, Eye Exam for diabetics, Children’s Access to Primary Care, and Adult Access to Preventive Care.
San Diego Medicaid HEDIS results
- Childhood Immunization: DT/DTP/DTaP, MMR, Varicella (90th percentile)
- Childhood Immunization: OPV/IPV, Hep B, Pneumococcal, Combination 2 &3 (75th percentile)
- Well Child Care: First 15 months of care for 6 or more visits (75th percentile)
- Well Child Care: Years 3 to 6 (75th percentile)
- URI Treatment (75th percentile)
- Timeliness of Prenatal Care (75th percentile)
- Controlling High Blood Pressure (75th percentile)
- Comprehensive Diabetes Care: HbA1c Poor Control (75th percentile)
San Diego HEDIS® measures with improvement included: Well Adolescent Care, URI Treatment, Breast Cancer Screening, Eye Exam for diabetics, Children’s Access to Primary Care, and Adult Access to Preventive Care.
Healthy Families Preventive Health Care
Well Child Care: age 3-6 (75th percentile)
Adolescent Well Care (75th percentile)
We will continue to offer programs to assist our providers and members to improve healthcare outcomes by encouraging annual wellness visits and the use of our disease management programs. We offer member incentives for these programs.
Examples of initiatives to assist in improving our HEDIS rates are:
- Provider missed services quarterly reporting
- Member missed services outreach reminder calls
- Provider Partnership programs
- Practitioner and member newsletters
- Multi-language translations for targeted Health Education and wellness mailings and disease management programs
Disease Management Program incentives for:
- Pediatric and adult asthma disease management - breathe with easesm
- Adult diabetes disease management - Healthy Living with Diabetessm
- motherhood matterssm program for pregnancy care that emphasizes timely prenatal and postpartum visits
For information about the disease management and other wellness programs, call (800) 526-8196 ext. 127532
If you have any questions, would like additional information about HEDIS®, or have suggestions for our Quality Improvement Program, please call 1-800-526-8196, Ext. 126137.
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