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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) |
40.51% |
41.81% |
≤36.00% |
Antidepressant Medication Management (AMM) Effective Acute Phase Treatment |
70.00% |
66.81% |
81.36% |
Antidepressant Medication Management (AMM) Effective Continuation Phase Treatment |
56.62% |
54.50% |
63.32% |
Asthma Medication Ratio (AMR) |
77.83% |
90.09% |
89.20% |
Appropriate Testing for Pharyngitis (CWP) |
65.91% |
62.57% |
72.10% |
Appropriate Treatment for Upper Respiratory Infection (URI) |
94.95% |
92.25% |
89.20% |
Avoidance of Antibiotic Treatment for Acute Bronchitis / Bronchiolitis (AAB) |
50.79% |
55.68% |
51.40% |
Breast Cancer Screening (BCS) |
66.95% |
64.65% |
74.60% |
Cervical Cancer Screening (CCS) |
59.12% |
59.37% |
65.10% |
Childhood Immunization Status (CIS) Combination #10 Total |
49.30% |
58.23% |
56.10% |
Chlamydia Screening in Women (CHL) Total |
44.21% |
43.21% |
51.10% |
Colorectal Cancer Screening (COL) |
53.53% |
49.39% |
64.80% |
Controlling High Blood Pressure (CBP) |
66.42% |
65.69% |
70.20% |
Eye Exam for Patients With Diabetes (EED) |
41.12% |
41.61% |
53.80% |
Follow-Up After Hospitalization for Mental Illness (FUH) 30-Day Rate Only |
50.00% |
44.78% |
79.38% |
Follow-Up After Hospitalization for Mental Illness (FUH) 7-Day Rate Total |
18.33% |
20.90% |
58.68% |
Hemoglobin A1c Control for Patients With Diabetes (HBD) |
66.67% |
67.88% |
66.10% |
Initiation and Engagement of Substance Use Disorder Treatment (IET) Initiation of SUD Treatment Total |
36.35% |
42.09% |
41.84% |
Initiation and Engagement of Substance Use Disorder Treatment (IET) Engagement of SUD Treatment Total |
6.97% |
4.48% |
15.22% |
Immunizations for Adolescents (IMA) Combination #2 Total |
41.67% |
37.21% |
34.00% |
International Normalized Ratio Monitoring for Individuals on Warfarin (INR) |
76.43% |
69.67% |
64.30% |
Kidney Health Evaluation for Patients With Diabetes (KED) |
NR |
54.36% |
51.40% |
Plan All-Cause Readmission (PCR) |
74.73% |
34.28% |
≤54.20% |
Prenatal and Postpartum Care (PPC) Timeliness of Prenatal Care |
94.06% |
90.02% |
90.40% |
Prenatal and Postpartum Care (PPC) Postpartum Care |
90.31% |
90.02% |
89.20% |
Proportion of Days Covered (PDC) RAS Antagonists |
70.18% |
71.32% |
83.50% |
Proportion of Days Covered (PDC) Diabetes All Class |
69.03% |
69.40% |
79.60% |
Proportion of Days Covered (PDC) Statins |
65.33% |
66.29% |
81.30% |
Use of Imaging Studies for Low Back Pain (LBP) |
78.59% |
72.34% |
79.10% |
Well-Child Visits in the First 30 Months of Life (W30) Well-Child Visits in the First 15 Months |
59.65% |
73.53% |
86.19% |
Well-Child Visits in the First 30 Months of Life (W30) Well-Child Visits for Age 15 Months-30 Months |
83.33% |
83.53% |
88.90% |
Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (WCC) BMI Percentile Total |
82.00% |
82.48% |
87.16% |
Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (WCC) Counseling for Nutrition Total |
73.24% |
70.80% |
80.40% |
Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (WCC) Counseling for Physical Activity Total |
70.56% |
68.86% |
77.44% |
Child and Adolescent Well-Care Visits (WCV) Total |
47.85% |
48.19% |
59.50% |
Molina Healthcare of Washington Overall Marketplace Quality Rating = 4 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