HEDIS® 2007 (NCQA Healthcare Effectiveness Data and Information Set)

Molina Healthcare of California participates in annual HEDIS® studies for California MediCal and Healthy Families quality reporting and voluntary NCQA (National Committee for Quality Assurance) accreditation process.  The 2007 HEDIS scores are based on the care members received through the end of 2006. 

There were improvements in many of our Riverside/San Bernardino and Sacramento 2007 HEDIS® scores including:

• Childhood Immunizations – Combo 3
• Adolescent Immunizations – Combo 2
• Well child care 0-15 months, ages 3-6 and adolescents
• Dilated retinal exams for diabetics
• Nephropathy monitoring for diabetics
• Cholesterol screenings (R/SB)
• Appropriate medications for asthmatics
• Breast cancer screening
• Chlamydia screening
• Timely Post Partum Care
• Timely Prenatal Care

Measures needing improvement in 2008 are:

• Cervical  cancer screenings
• HbA1c testing and LDL-C screening for diabetics
• Children with pharyngitis
• Controlling high blood pressure
• Adult access to preventive care

This was our first year reporting San Diego rates; we are pleased to report all measures scored between the 50th and 90th NCQA Medicaid percentile. Many Healthy Families rates also improved. 

 Links to the 2007 HEDIS scores for each service area are posted below.

San Bernardino/Riverside Medicaid HEDIS results

Sacramento Medicaid HEDIS results

San Diego Medicaid HEDIS results

Healthy Families Preventive Health Care

Examples of interventions designed to encourage our practitioners to provide and members to seek preventive care services include:

• Incentive programs for members and practitioners for wellness care
• Welcome calls to all new members with assistance in scheduling initial health assessments
• Health Education targeted wellness mailings
• Practitioner and member newsletters
• Multi-language translations for specific programs
• Disease Management Program incentives for Asthma - the breathe with ease pediatric and adult asthma disease management, Diabetes - Living Well with Diabetes adult diabetes disease management and motherhood mattersSM  program for pregnancy care, including completion of 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.

Molina values the care and service, health education and advice you give to our members. Our quality improvement program 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.