HEDIS® Results

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HEDIS®  Results

Marketplace HEDIS® Annual Rates.

Molina’s scores for the past two years are below. You can see how Molina performs compared to our target goal.

Measure / Data Element

2020

2021

2021 Goal

Annual Dental Visit (ADV)

NB

NB

42.34%

Antidepressant Medication Management (AMM) Effective Acute Phase Treatment

67.86%

70.11%

79.55%

Antidepressant Medication Management (AMM) Effective Continuation Phase Treatment

51.79%

58.62%

63.23%

Asthma Medication Ratio (AMR)

NR

84.38%

86.69%

Appropriate Testing for Pharyngitis (CWP)

63.90%

48.34%

76.83%

Appropriate Treatment for Upper Respiratory Infection (URI)

75.66%

81.58%

85.62%

Avoidance of Antibiotic Treatment for Acute Bronchitis / Bronchiolitis (AAB)

45.45%

41.22%

46.67%

Breast Cancer Screening (BCS)

65.53%

64.72%

71.73%

Cervical Cancer Screening (CCS)

64.23%

48.18%

64.97%

Childhood Immunization Status (CIS) Combination #3 Total

NA

66.67%

80.45%

Chlamydia Screening in Women (CHL) Total

49.35%

48.94%

52.96%

Colorectal Cancer Screening (COL)

52.80%

46.47%

63.75%

Comprehensive Diabetes Care (CDC) Eye Exam (Retinal) Performed

55.40%

40.15%

52.80%

Comprehensive Diabetes Care (CDC) HbA1c Control (<8.0%)

68.18%

49.64%

60.88%

Comprehensive Diabetes Care (CDC) Monitoring for Nephropathy

93.75%

92.70%

90.75%

Controlling High Blood Pressure (CBP)

72.70%

59.61%

65.45%

Follow-Up After Hospitalization for Mental Illness (FUH) 7-Day Rate Only

54.55%

30.30%

50.00%

Immunizations for Adolescents (IMA) Combination #2 Total

28.57%

36.84%

33.33%

Initiation and Engagement of Alcohol and Other Drug Dependence Treatment (IET) Initiation of AOD Treatment Rate Total

35.19%

35.77%

41.25%

Initiation and Engagement of Alcohol and Other Drug Dependence Treatment (IET) Engagement of AOD Treatment Rate Total

5.56%

8.03%

13.76%

Plan All-Cause Readmission (PCR)

57.96%

26.31%

52.22%

Prenatal and Postpartum Care (PPC) Timeliness of Prenatal Care

96.88%

75.00%

90.63%

Prenatal and Postpartum Care (PPC) Postpartum Care

90.63%

70.00%

86.32%

Proportion of Days Covered (PDC) RAS Antagonists

73.88%

70.75%

83.13%

Proportion of Days Covered (PDC) Diabetes All Class

63.61%

64.82%

80.23%

Proportion of Days Covered (PDC) Statins

65.01%

66.16%

81.65%

Use of Imaging Studies for Low Back Pain (LBP)

72.41%

80.85%

82.86%

Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC) BMI Screening Total

90.00%

80.10%

83.18%

Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC) Counseling for Nutrition Total

85.00%

73.55%

77.43%

Weight Assessment and Counseling for Nutrition and Physical Activity for Children/ Adolescents (WCC) Counseling on Physical Activity Total

83.46%

73.05%

75.91%

Well-Child Visits in the First 30 Months of Life (W30) Well-Child Visits in the First 15 Months

NA

NA

85.00%

Well-Child Visits in the First 30 Months of Life (W30) Well-Child Visits for Age 15 Months – 30 Months

NR

NA

90.35%

Child and Adolescent Well-Care Visits (WCV) Total

80.00%

43.60%

56.68%

 

Molina Healthcare of Michigan Overall Marketplace Quality Rating = 3 Stars

CMS rates qualified health plans (QHPs) offered through the Exchanges using the Quality Rating System (QRS), which is based on third-party validated clinical measure data and QHP Enrollee Survey response data. CMS calculates QRS ratings annually using a 5-star scale. QHP issuers contract with HHS-approved survey vendors that independently conduct the QHP Enrollee Survey each year. QRS ratings and QHP Enrollee Survey results may change from one year to the next. For more information, please see CMS’ Health Insurance MarketplaceSM  Quality Initiatives website at: CMS.gov

NA = Not Available Due to Small Denominator
NB = No Benefit
NR = Not Reported
NQ = Not Required
BR = Biased Rate

 

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