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

51.84%

60.59%

79.55%

Antidepressant Medication Management (AMM) Effective Continuation Phase Treatment

35.47%

45.56%

63.23%

Asthma Medication Ratio (AMR)

NR

82.07%

86.69%

Appropriate Testing for Pharyngitis (CWP)

53.53%

52.95%

76.83%

Appropriate Treatment for Upper Respiratory Infection (URI)

58.23%

62.72%

85.62%

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

27.84%

30.23%

46.67%

Breast Cancer Screening (BCS)

62.12%

59.54%

71.73%

Cervical Cancer Screening (CCS)

51.82%

49.39%

64.97%

Childhood Immunization Status (CIS) Combination #3 Total

73.12%

67.09%

80.45%

Chlamydia Screening in Women (CHL) Total

43.74%

39.39%

52.96%

Colorectal Cancer Screening (COL)

33.33%

41.36%

63.75%

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

43.55%

36.98%

52.80%

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

54.26%

54.74%

60.88%

Comprehensive Diabetes Care (CDC) Medical Attention for Nephropathy

91.24%

91.48%

90.75%

Controlling High Blood Pressure (CBP)

46.47%

40.39%

65.45%

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

36.65%

34.96%

50.00%

Immunizations for Adolescents (IMA) Combination #2 Total

15.82%

19.46%

33.33%

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

29.80%

27.76%

41.25%

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

3.40%

3.64%

13.76%

Plan All-Cause Readmission (PCR)

51.71%

59.31%

52.22%

Prenatal and Postpartum Care (PPC) Timeliness of Prenatal Care

91.48%

82.97%

90.63%

Prenatal and Postpartum Care (PPC) Postpartum Care

71.29%

68.13%

86.32%

Proportion of Days Covered (PDC) RAS Antagonists

60.29%

65.07%

83.13%

Proportion of Days Covered (PDC) Diabetes All Class

57.51%

63.33%

80.23%

Proportion of Days Covered (PDC) Statins

50.09%

57.04%

81.65%

Use of Imaging Studies for Low Back Pain (LBP)

71.71%

76.52%

82.86%

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

BMI Percentile Total

54.28%

70.56%

83.18%

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

Counseling for Nutrition Total

54.52%

62.04%

77.43%

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

Counseling for Physical Activity Total

49.88%

60.34%

75.91%

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

61.59%

65.10%

85.00%

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

NR

80.73%

90.35%

Child and Adolescent Well-Care Visits (WCV) Total

66.99%

36.75%

56.68%

 

Molina Healthcare of Texas 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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