HEDIS® Results

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HEDIS® Results

Marketplace Healthcare Effectiveness Data and Information Set (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

2021

2022

Goal

Annual Dental Visit (ADV)

NB

NB

37.80%

Asthma Medication Ratio (AMR)

NA

80.65%

86.00%

Appropriate Testing for Pharyngitis (CWP)

70.18%

61.93%

70.80%

Appropriate Treatment for Upper Respiratory Infection (URI)

63.37%

68.63%

91.50%

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

42.50%

38.13%

50.20%

Breast Cancer Screening (BCS)

NA

NA

71.70%

Cervical Cancer Screening (CCS)

18.19%

34.31%

66.20%

Childhood Immunization Status (CIS) Combination #10 Total

NR

NA

60.20%

Chlamydia Screening in Women (CHL) Total

42.16%

49.72%

53.60%

Colorectal Cancer Screening (COL)

NA

33.82%

65.70%

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

22.48%

28.22%

53.30%

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

23.65%

54.99%

64.30%

Controlling High Blood Pressure (CBP)

15.29%

56.45%

68.60%

Immunizations for Adolescents (IMA) Combination #2 Total

NA

NA

33.10%

Prenatal and Postpartum Care (PPC) Timeliness of Prenatal Care

NA

82.35%

90.50%

Prenatal and Postpartum Care (PPC) Postpartum Care

NA

78.82%

88.80%

Proportion of Days Covered (PDC) RAS Antagonists

61.82%

63.27%

81.60%

Proportion of Days Covered (PDC) Diabetes All Class

59.70%

64.30%

80.10%

Proportion of Days Covered (PDC) Statins

61.34%

59.87%

80.80%

Use of Imaging Studies for Low Back Pain (LBP)

75.51%

71.33%

81.60%

Child and Adolescent Well-Care Visits (WCV) Total

27.03%

29.34%

59.70%

Molina Healthcare of South Carolina Overall Marketplace Quality Rating = 2 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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