HEDIS^® 2008 and CAHPS^® Results

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 performance. The HEDIS^® report is based on the care that MHNM’s Members received through the end of 2007.

Improvements were seen in many of MHNM’s 2008 HEDIS^® scores. Specific results can be viewed by clicking on the link below:

Three-Year Trending

• Improved performance on 34 of 47 measures from 2006 to 2008 (72%)
• Average improved of 13.8 percentage points from 2006 to 2008 - simple average for all reported measures

• Improved performance on 27 of 47 measures from 2007 to 2008 (57%)
• Average improvement of 2.9 percentage points from 2007 to 2008 -- simple average for all reported measures

• Exceeded 90^th percentile for 8 of 18 measures
• Exceeded 75^th percentile for 10 of 18 measures

• Exceeded 75^th percentile for 12 of 48 measures
• Of these, 8 exceeded the 90^th percentile
• Obtained or exceeded the Molina goal of the 75th percentile for 25% of reported measures.

MHNM's HEDIS^® rates reflect the quality of care provided to Members. MHNM is very encouraged by the significant increases in well-care rates for infants and adolescents. Well-Child Visits in the First 15 Months of Life (6 or more visits) increased from 50% to 63% in 2008, while the Adolescent Well-Care Visits rate increased from 41% to 51%.

Following a drop in MHNM’s Cervical Cancer Screening rate in 2007, this measure climbed again in 2008, placing the health plan above the 90^th accreditation percentile for Medicaid at 67%. Annual Dental Visits continues to show significant improvement, and now places MHNM above the 90^th percentile for its combined rate when compared to NCQA’s national benchmarks from 2007.

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 Comprehensive Diabetes Care and the combined rate for Use of Appropriate Medications for Asthma exhibited significant decreases in 2008, 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 care as early as possible, MHNM provides a convertible car seat upon completion of a qualifying maternity education class and a car seat safety class.
• A “You Don’t Have to Let Your Baby Cry” Baby-Go-To-Sleep CD is included in packets sent to postpartum Members.
• Immunization 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.
• Adolescents and children receive cards 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.
• Annual Breast Cancer and Cervical Cancer Screening (including Chlamydia Screening) reminder letters are also sent to Members. Calls are also made to members who may have missed these screenings.

CAHPS^®

MHNM annually measures satisfaction using the CAHPS^® (Consumer Assessment of Healthcare Providers and Systems) 4.0H survey. This survey looks at key satisfaction drivers throughout the continuum of care, including health plan performance and Members' experiences in their physicians’ offices. The 2008 CAHPS^® survey results show that MHNM’s Members are very satisfied with their overall care and health plan.

*The number of the respondents for the CAHPS^® Customer Service composite score is too small to produce a reportable score for NCQA (n=84). Percentile ranking is as compared to 2007 NCQA national benchmarks.

No CAHPS^® score experienced a significant change from 2007 to 2008. 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 the practitioner and MHNM to improve the overall health and quality of care provided to all Members.

For more information on MHNM 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. For more information about HEDIS^® or CAHPS^®, please call the MHNM Manager of Quality Analysis at 1-(800)-337-9594 Ext. 180217.

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