HEDIS® Results
Medicare 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) |
28.02 |
30.24 |
52.39 |
|
|
Adult Immunization Status (AIS-E) - Pneumococcal (66+) |
29.79 |
39.13 |
70.17 |
|
|
Adult Immunization Status (AIS-E) - Td/Tdap (Total) |
25.12 |
29.03 |
44.31 |
|
|
Breast Cancer Screening (BCS-E) |
53.66 |
65.85 |
79.14 |
|
|
Colorectal Cancer Screening (COL-E) -Total |
50.00 |
55.15 |
76.97 |
|
|
Respiratory |
||||
|
Appropriate Testing for Pharyngitis (CWP) -Total |
0.00 |
NR |
70.83 |
|
|
Pharmacotherapy Management of COPD Exacerbation (PCE) - Bronchodilator |
0.00 |
0.00 |
88.82 |
|
|
Pharmacotherapy Management of COPD Exacerbation (PCE) -Systemic Corticosteroid |
0.00 |
100.00 |
78.88 |
|
|
Cardiovascular |
||||
|
Cardiac Rehabilitation (CRE) - Initiation (Total) |
0.00 |
0.00 |
7.20 |
|
|
Cardiac Rehabilitation (CRE) - Engagement1 (Total) |
0.00 |
0.00 |
11.23 |
|
|
Cardiac Rehabilitation (CRE) - Engagement2 (Total) |
0.00 |
0.00 |
10.76 |
|
|
Cardiac Rehabilitation (CRE) - Achievement (Total) |
0.00 |
0.00 |
5.00 |
|
|
Controlling High Blood Pressure (CBP) |
75.95 |
73.87 |
82.48 |
|
|
Persistence of Beta-Blocker Treatment After a Heart Attack (PBH) |
NR |
100.00 |
77.42 |
|
|
Statin Therapy for Patients With Cardiovascular Disease (SPC) - Received Statin Therapy (Total) |
81.82 |
83.33 |
83.55 |
|
|
Statin Therapy for Patients With Cardiovascular Disease (SPC) - Statin Adherence 80% (Total) |
55.56 |
66.67 |
87.66 |
|
|
Diabetes |
||||
|
Blood Pressure Control for Patients With Diabetes (BPD) |
72.58 |
72.50 |
80.78 |
|
|
Eye Exam for Patients With Diabetes (EED) |
54.84 |
72.50 |
83.21 |
|
|
Glycemic Status Assessment for Patients With Diabetes (GSD) - Glycemic Status 8.0% |
72.58 |
57.50 |
79.05 |
|
|
Kidney Health Evaluation for Patients With Diabetes (KED) - Total |
48.28 |
63.29 |
70.33 |
|
|
Statin Therapy for Patients With Diabetes (SPD) - Received Statin Therapy |
80.00 |
70.27 |
83.55 |
|
|
Statin Therapy for Patients With Diabetes (SPD) - Statin Adherence 80% |
65.00 |
80.77 |
87.66 |
|
|
Musculoskeletal Conditions |
||||
|
Osteoporosis Management in Women Who Had a Fracture (OMW) |
NR |
NR |
58.06 |
|
|
Osteoporosis Screening in Older Women (OSW) |
36.36 |
48.72 |
62.81 |
|
|
Behavioral Health |
||||
|
Adherence to Antipsychotic Medications for Individuals With Schizophrenia (SAA) |
NR |
60.00 |
85.37 |
|
|
Antidepressant Medication Management (AMM) - Effective Acute Phase Treatment |
80.00 |
92.31 |
86.11 |
|
|
Antidepressant Medication Management (AMM) - Effective Continuation Phase Treatment |
60.00 |
76.92 |
72.56 |
|
|
Follow-Up After Emergency Department Visit for Mental Illness (FUM) - 30 days (Total) |
0.00 |
NR |
61.63 |
|
|
Follow-Up After Emergency Department Visit for Mental Illness (FUM) - 7 days (Total) |
0.00 |
NR |
44.44 |
|
|
Follow-Up After Emergency Department Visit for Substance Use (FUA) - 30 days (Total) |
33.33 |
100.00 |
47.79 |
|
|
Follow-Up After Emergency Department Visit for Substance Use (FUA) - 7 days (Total) |
16.67 |
100.00 |
31.07 |
|
|
Follow-Up After High-Intensity Care for Substance Use Disorder (FUI) - 30 days (Total) |
0.00 |
25.00 |
49.00 |
|
|
Follow-Up After High-Intensity Care for Substance Use Disorder (FUI) - 7 days (Total) |
0.00 |
25.00 |
26.19 |
|
|
Follow-Up After Hospitalization for Mental Illness (FUH) - 30 days (Total) |
75.00 |
28.57 |
62.38 |
|
|
Follow-Up After Hospitalization for Mental Illness (FUH) - 7 days (Total) |
50.00 |
14.29 |
40.00 |
|
|
Pharmacotherapy for Opioid Use Disorder (POD) -Total |
50.00 |
0.00 |
38.83 |
|
|
Care Coordination |
||||
|
Advance Care Planning (ACP) |
76.60 |
69.09 |
67.98 |
|
|
Follow-Up After Emergency Department Visit for People With Multiple High-Risk Chronic Conditions (FMC) -Total |
42.86 |
60.00 |
67.64 |
|
|
Transitions of Care (TRC) - Medication Reconciliation Post-Discharge (Total) |
33.65 |
42.62 |
88.08 |
|
|
Transitions of Care (TRC) - Notification of Inpatient Admission (Total) |
5.77 |
6.56 |
72.50 |
|
|
Transitions of Care (TRC) - Patient Engagement After Inpatient Discharge (Total) |
69.23 |
67.21 |
91.97 |
|
|
Transitions of Care (TRC) - Receipt of Discharge Information (Total) |
6.73 |
3.28 |
49.94 |
|
|
Appropriateness of Use |
||||
|
Appropriate Treatment for Upper Respiratory Infection (URI) -Total |
100.00 |
83.33 |
75.54 |
|
|
Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB) - Total |
50.00 |
0.00 |
39.42 |
|
|
Use of Imaging Studies for Low Back Pain (LBP) - Total |
100.00 |
57.14 |
57.14 |
|
|
Access and Availability of Care |
||||
|
Adults' Access to Preventive/Ambulatory Health Services (AAP) - Total |
85.02 |
86.29 |
97.45 |
|
|
Initiation and Engagement of Substance Use Disorder Treatment (IET) - Initiation of SUD Treatment - Total |
42.86 |
73.68 |
45.13 |
|
|
Initiation and Engagement of Substance Use Disorder Treatment (IET) - Engagement of SUD Treatment - Total |
0.00 |
5.26 |
7.90 |
|
Every year, Medicare evaluates plans based on a 5-star rating system. For STAR ratings, please visit Medicare Plan Finder or CMS.gov.
NR = Not Reported