HEDIS^®

Molina Healthcare of Utah uses the Healthcare Effectiveness Data and Information Set (HEDIS®) tool each year as a way to measure the quality. This is done by looking at the type of care and service provided. HEDIS® is maintained by NCQA. The tool allows for review of certain aspects of care. This includes clinical and non-clinical care. It also shows where plans can improve care and service. Molina’s goal is to be better than 75% of other Medicaid health plans in the nation.

Molina Healthcare of Utah has seen the following improvements in HEDIS^® rates:

Medicaid

Measures that increased from 75th to 90th percentile.

• Appropriate testing for Children with Pharyngitis
• Use of Imaging Studies for Low Back Pain

Measures that increased to the 75th percentile

• Use of Spirometry Testing in the Assessment of Diagnosis of COPD
• Cervical Cancer Screening

Measures where we met our goal of the 75th percentile.

• Use of Spirometry Testing in the Assessment of Diagnosis of COPD
• Childhood immunizations
• Upper respiratory Treatment
• Prenatal Care
• Postpartum Care
• Frequency of Prenatal Care
• Controlling High Blood Pressure
• Diabetic Care: HbA1C testing
• Diabetic Care: Good Control
• Diabetic Care: LDL Screening
• Diabetic Care: Monitoring for Nephrology
• Diabetic Care: Eye Exam
• Appropriate Medications for Asthma
• Cholesterol Management
• Advice to Quit Smoking
• Avoidance of Antibiotic Treatment
• Rating of Personal Doctor/Nurse
• Rating of Specialist Seen Most
• Rating of All Health Care
• Getting Care Quickly
• Getting Needed Care
• How Well Doctors Communicate

Detailed results can be found by clicking here: 2011 HEDIS® Rates

Medicare

Measure where we met our goal of the 75th percentile.

• Controlling High Blood Pressure
• Diabetic Care: Blood Pressure Control (<130/80)
• Diabetic Care: Blood Pressure Control (<140/90)
• Diabetic Care: HbA1C testing
• Diabetic Care: Good Control
• Diabetic Care: LDL Screening
• Diabetic Care: Monitoring for Nephrology
• Diabetic Care: Eye Exam

Detailed results can be found by clicking here: 2011 HEDIS® Medicare Rates

CAHPS^®

The CAHPS^® (Consumer Assessment of Healthcare Providers and Systems) survey is also maintained by NCQA. The survey is performed each year. It measures how happy members are with the health plan and the service received from doctors.

Molina Healthcare of Utah has seen the following improvements in CAHPS^® rates:

Medicaid

More than half (54.5%) gave their health plan an overall rating of 9 or 10 on a 0 to 10 scale, which is higher than last year, higher than the 2010 QC Average.

Improvements were seen in the following measures:

• Getting Care Quickly
• How Well Doctors Communicate

Medicare

• Pneumonia Vaccination
• Flu Vaccination
• Overall Rating of Prescription Drug Plan
• Overall Rating of Health Plan
• Overall Rating of Health Care Quality
• Getting Appointments and Care Quickly

Detailed results can be found by clicking here: 2011 CAHPS® Survey Results

If you have any questions or would like additional information about HEDIS^®or CAHPS^® please contact Christopher Stock, Director of Quality Improvement at 801-316-9541.

HEDIS^® is a Registered Trademark of the National Committee for Quality Assurance.

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