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:

Icon PDF 2013 HEDIS® Rates

Icon PDF 2011 HEDIS® Medicare

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

HEDIS® is a Registered Trademark of the National Committee for Quality Assurance.

 

 

 

 

 

 

 

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