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Quality Improvement

The Quality of Care You Receive is Important to Us

Molina Healthcare wants you and your family to receive the best care. We have a Quality Improvement (QI) Program to ensure you get quality care. Each year Molina Healthcare sets goals to improve our services. One goal is to help you take better care of yourself and your family.

The QI Program:

  • Evaluates providers to be sure you have access to a qualified health care team
  • Investigates and takes action when you have an issue with the quality of care you have been provided
  • Promotes safety in health care through education for you and our providers
  • Publishes Preventive Health Guidelines to help you know what services you need and when
  • Evaluates the quality of your healthcare through HEDIS® (Healthcare Effectiveness Data and Information Set). These scores tell us when you have received the type of care you need. The scores look at how often you receive services such as well visits, immunizations, eye tests, cholesterol tests, and prenatal and postpartum care if you are pregnant.

Evaluates members' satisfaction with care through the CAHPS Survey (Consumer Assessment of Healthcare Providers and Systems) conducted by ODJFS. This tells us if you are happy with your health plan and your health care providers. It also tells us what we can make better for you.

Improving Services to Molina Healthcare Members

  • Your health care is important to us. That is why we produce HEDIS® scores to tell us if you are receiving the care recommended for you.
Some Areas Where Care Improved This Year Some Areas For Improvement Next Year
Children's Well Care Adolescent Well Visits
Children's Dental Visits Children's Immunizations
Cervical Cancer Screening in Women Lead Screening in Children
Chlamydia Screening in Women Annual Eye Exams for Members with Diabetes
Controlling High Blood Pressure  Care for Mothers During Pregnancy
Blood Tests for Patients with Diabetes Care for Mothers After Delivery
Medication Use After a Heart Attack Management of Antidepressant Medications
  • Some of the things we have done to help improve our scores this year include:
    - A member incentive program promoting use of preventive services
    - Our motherhood matters educational and incentive program for pregnant members
    - Reminder postcards and calls for missed immunizations
    - Reminder postcards for prenatal and postpartum care
    - An “Alert” system that prompts us to remind members of services they may have missed when they call our   Member Services department
    - Educational pamphlets in provider offices that focus on recommended preventive services
    - Educational articles in our Member Newsletter that focus on preventive care

To learn more or to request a copy of our QI program, call Member Services.

*Printed copies of information posted on our website are available upon request.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).