HEDIS®
Molina Healthcare of California uses the Healthcare Effectiveness Data and Information Set (HEDIS®) tool each year as a way to measure the quality. This is done by looking at the type of care and service provided. HEDIS® is maintained by NCQA. The tool allows for review of certain aspects of care. This includes clinical and non-clinical care. It also shows where plans can improve care and service. Molina's goal is to be better than 75 percent of other Medicaid health plans in the nation.
Molina Healthcare of California has seen the following improvements in HEDIS® rates:
Medicaid
All Counties
- Treatment of Upper Respiratory Infection
- Adolescent Immunizations
Riverside/San Bernardino
- LDL-C < 100mg/dL persons with Heart Disease
- Adult BMI Assessment
Sacramento
- Breast Cancer Screening
- HbA1C Testing for Diabetics
- LDL-C < 100mg/dL for Diabetics
San Diego
- Cervical Cancer Screening
- LDL-C < 100mg/dL for Diabetics
- Dilated Retinal Eye Exams for Diabetics (DRE)
Healthy Families
- Treatment of Upper Respiratory Infection
- Chlamydia Screening in Women
- Lead Screening
Medicare
- Adult BMI
- Colorectal Cancer Screening
- Glaucoma Screening in Older Adults
- Controlling High Blood Pressure
- HbA1C Testing for Diabetics
- HbA1c Control for Diabetics
- Blood Pressure < 140/80 for Diabetics
- Dilated Retinal Eye Exams for Diabetics (DRE)
- LDL-C < 100mg/dL for Diabetics
- LDL-C Screening for Persons with Heart Disease
Detailed results can be found by clicking the following links:
If you have any questions or would like additional information about HEDIS® please contact the following:
Providers: Quality Improvement Department at (800)526-8196 Ext. 126137
Members: Customer Service Department at (888)665-4621
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