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

2022

2023

Goal

Annual Dental Visit (ADV)

NB

NB

40.40%

Annual Monitoring for Persons on Long-term Opioid Therapy (AMO)

50.98%

46.95%

≤36.00%

Antidepressant Medication Management (AMM) Effective Acute Phase Treatment

67.80%

64.89%

81.36%

Antidepressant Medication Management (AMM) Effective Continuation Phase Treatment

54.24%

50.84%

63.32%

Asthma Medication Ratio (AMR)

80.65%

80.56%

89.20%

Appropriate Testing for Pharyngitis (CWP)

61.93%

68.09%

72.10%

Appropriate Treatment for Upper Respiratory Infection (URI)

68.63%

69.77%

89.20%

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

38.13%

39.59%

51.40%

Breast Cancer Screening (BCS)

NA

65.78%

74.60%

Cervical Cancer Screening (CCS)

34.31%

38.44%

65.10%

Childhood Immunization Status (CIS) Combination #10 Total

NA

NA

56.10%

Chlamydia Screening in Women (CHL) Total

49.72%

50.81%

51.10%

Colorectal Cancer Screening (COL)

33.82%

40.88%

64.80%

Controlling High Blood Pressure (CBP)

56.45%

53.04%

70.20%

Eye Exam for Patients With Diabetes (EED)

28.22%

68.09%

53.80%

Follow-Up After Hospitalization for Mental Illness (FUH) 30 Day Follow-Up Total

49.33%

36.96%

79.38%

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

32.00%

23.91%

58.68%

Hemoglobin A1c Control for Patients With Diabetes (HBD)

54.99%

50.85%

66.10%

Initiation and Engagement of Substance Use Disorder Treatment (IET) Initiation of SUD Treatment Total

38.04%

49.69%

41.84%

Initiation and Engagement of Substance Use Disorder Treatment (IET) Engagement of SUD Treatment Total

6.25%

9.24%

15.22%

Immunizations for Adolescents (IMA) Combination #2 Total

NA

NA

34.00%

International Normalized Ratio Monitoring for Individuals on Warfarin (INR)

41.46%

43.75%

64.30%

Kidney Health Evaluation for Patients With Diabetes (KED)

*

32.60%

51.40%

Prenatal and Postpartum Care (PPC) Timeliness of Prenatal Care

82.35%

77.42%

90.40%

Prenatal and Postpartum Care (PPC) Postpartum Care

78.82%

78.06%

89.20%

Proportion of Days Covered (PDC) RAS Antagonists

63.27%

64.72%

83.50%

Proportion of Days Covered (PDC) Diabetes All Class

64.30%

62.70%

79.60%

Proportion of Days Covered (PDC) Statins

59.87%

59.56%

81.30%

Use of Imaging Studies for Low Back Pain (LBP)

71.33%

67.42%

79.10%

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

NA

NA

86.19%

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

NA

NA

88.90%

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

66.18%

63.02%

87.16%

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

49.39%

56.93%

80.40%

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

49.15%

55.23%

77.44%

Child and Adolescent Well-Care Visits (WCV) Total

29.34%

31.97%

59.50%

Molina Healthcare of South Carolina 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.

 

* Not Reported in 2022

NA = Not Available Due to Small Denominator

NB = No Benefit

NR = Not Reported

NQ = Not Required

BR = Biased Rate

                            

 

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