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Notice of Conduent Data Breach
Molina Healthcare (“Molina”) recently received notification from Conduent Business Services, LLC (“Conduent”) of a data breach. Conduent, a vendor and business associate of Molina, provides credit balance auditing services for certain Molina providers. The incident involved the protected health information of some Molina members. For more details about this incident, the response, and the resources available to help members protect themselves, please refer to Conduent’s substitute notice here. For additional information or questions, please call (866) 291-3678.
Marketplace HEDIS® (Healthcare Effectiveness Data and Information Set) Results
Molina’s scores for the past two years are below. You can see how Molina performs compared to our target goal.
The HEDIS® reporting year is the year after the data was collected. For example, “2024 Rate” includes data from January to December 2023 and “2025 Rate” includes data from January to December 2024.
|
Measure |
2024 Rate |
2025 Rate |
Goal |
|
Prevention and Screening |
|||
|
Adult Immunization Status (AIS-E) - Influenza (Total) |
23.15 |
12.17 |
24.30 |
|
Adult Immunization Status (AIS-E) - Pneumococcal (66+) |
66.67 |
12.50 |
52.50 |
|
Adult Immunization Status (AIS-E) - Td/Tdap (Total) |
41.22 |
38.67 |
47.50 |
|
Breast Cancer Screening (BCS-E) |
64.29 |
52.94 |
76.77 |
|
Cervical Cancer Screening (CCS) |
55.41 |
49.64 |
65.03 |
|
Childhood Immunization Status (CIS) - Combo 10 |
35.29 |
0.00 |
46.88 |
|
Chlamydia Screening in Women (CHL) Total |
65.00 |
33.02 |
56.04 |
|
Colorectal Cancer Screening (COL-E) -Total |
35.44 |
42.59 |
60.80 |
|
Immunizations for Adolescents (IMA) - Combination 2 |
33.33 |
0.00 |
36.86 |
|
Immunizations for Adolescents (IMA) - HPV |
33.33 |
0.00 |
32.70 |
|
Immunizations for Adolescents (IMA) - Meningococcal |
88.89 |
87.50 |
80.90 |
|
Immunizations for Adolescents (IMA) - Tdap |
88.89 |
87.50 |
86.40 |
|
Oral Evaluation, Dental Services (OED) - Total |
NB |
NB |
24.19 |
|
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC) - BMI percentile (Total) |
77.88 |
68.37 |
84.30 |
|
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC) - Counseling for Nutrition (Total) |
68.27 |
58.64 |
77.20 |
|
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC) - Counseling for Physical Activity (Total) |
63.46 |
55.96 |
74.80 |
|
Respiratory |
|||
|
Asthma Medication Ratio (AMR) -Total |
100.00 |
83.33 |
84.65 |
|
Cardiovascular |
|
|
|
|
Controlling High Blood Pressure (CBP) |
61.05 |
35.90 |
73.97 |
|
Diabetes |
|||
|
Eye Exam for Patients With Diabetes (EED) |
34.18 |
43.28 |
53.33 |
|
Glycemic Status Assessment for Patients With Diabetes (GSD) - Glycemic Status >9.0% Note: this is an inverse measure, meaning a rate lower than the goal indicates better performance. |
39.24 |
26.87 |
19.71 |
|
Kidney Health Evaluation for Patients With Diabetes (KED) - Total |
38.46 |
56.28 |
58.43 |
|
Behavioral Health |
|||
|
Antidepressant Medication Management (AMM) - Effective Acute Phase Treatment |
60.71 |
56.76 |
82.80 |
|
Antidepressant Medication Management (AMM) - Effective Continuation Phase Treatment |
48.81 |
45.95 |
67.20 |
|
Follow-Up After Hospitalization for Mental Illness (FUH) - 30 days (Total) |
80.00 |
66.67 |
71.80 |
|
Follow-Up After Hospitalization for Mental Illness (FUH) - 7 days (Total) |
60.00 |
48.15 |
50.00 |
|
Depression Screening and Follow-Up for Adolescents and Adults (DSF-E) - Depression Screening (Total) |
NR |
17.66 |
9.30 |
|
Depression Screening and Follow-Up for Adolescents and Adults (DSF-E) - Follow-Up on Positive Screen (Total) |
NR |
88.00 |
84.90 |
|
Appropriateness of Use |
|||
|
Appropriate Treatment for Upper Respiratory Infection (URI) -Total |
90.83 |
87.15 |
85.12 |
|
Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB) - Total |
62.22 |
54.17 |
54.88 |
|
Use of Imaging Studies for Low Back Pain (LBP) - Total |
75.00 |
71.43 |
75.53 |
|
Access and Availability of Care |
|||
|
Initiation and Engagement of Substance Use Disorder Treatment (IET) - Initiation of SUD Treatment - Total (Total) |
59.46 |
37.50 |
46.10 |
|
Initiation and Engagement of Substance Use Disorder Treatment (IET) - Engagement of SUD Treatment - Total (Total) |
21.62 |
12.50 |
15.90 |
|
Prenatal and Postpartum Care (PPC) - Timeliness of Prenatal Care |
75.93 |
77.08 |
89.51 |
|
Prenatal and Postpartum Care (PPC) - Postpartum Care |
87.04 |
63.54 |
88.89 |
|
Utilization |
|||
|
Child and Adolescent Well-Care Visits (WCV) - Total |
58.50 |
44.84 |
58.56 |
|
Well-Child Visits in the First 30 Months of Life (W30) - (First 15 Months) |
50.00 |
87.50 |
85.20 |
|
Well-Child Visits in the First 30 Months of Life (W30) - (15 Months-30 Months) |
69.23 |
66.67 |
90.50 |
Molina Healthcare of Utah 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.
NB = No Benefit
NR = Not Reported