HEDIS® Results

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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)

48.84%

72.22%

≤36.00%

Antidepressant Medication Management (AMM)

Effective Acute Phase Treatment

68.91%

74.67%

81.36%

Antidepressant Medication Management (AMM)

Effective Continuation Phase Treatment

51.26%

64.00%

63.32%

Asthma Medication Ratio (AMR)

87.50%

NA

89.20%

Appropriate Testing for Pharyngitis (CWP)

33.33%

43.75%

72.10%

Appropriate Treatment for Upper Respiratory Infection (URI)

74.07%

67.91%

89.20%

Avoidance of Antibiotic Treatment for Acute Bronchitis / Bronchiolitis (AAB)

40.45%

40.51%

51.40%

Breast Cancer Screening (BCS)

52.51%

55.82%

74.60%

Cervical Cancer Screening (CCS)

54.26%

58.15%

65.10%

Childhood Immunization Status (CIS) Combination #10 Total

47.06%

NA

56.10%

Chlamydia Screening in Women (CHL) Total

54.09%

57.30%

51.10%

Colorectal Cancer Screening (COL)

34.57%

33.83%

64.80%

Controlling High Blood Pressure (CBP)

59.85%

62.29%

70.20%

Eye Exam for Patients With Diabetes (EED)

25.55%

24.82%

53.80%

Follow-Up After Hospitalization for Mental Illness (FUH) 30-Day Rate Only

18.92%

28.13%

79.38%

Follow-Up After Hospitalization for Mental Illness (FUH) 7-Day Rate Total

16.22%

21.88%

58.68%

Hemoglobin A1c Control for Patients With Diabetes (HBD)

57.91%

57.42%

66.10%

Initiation and Engagement of Substance Use Disorder Treatment (IET) Initiation of SUD Treatment Total

28.04%

43.48%

41.84%

Initiation and Engagement of Substance Use Disorder Treatment (IET) Engagement of SUD Treatment Total

5.82%

8.70%

15.22%

Immunizations for Adolescents (IMA) Combination #2 Total

NA

NA

34.00%

International Normalized Ratio Monitoring for Individuals on Warfarin (INR)

31.25%

NA

64.30%

Kidney Health Evaluation for Patients With Diabetes (KED)

*

49.68%

51.40%

Plan All-Cause Readmission (PCR)

76.52%

80.29%

≤ 54.20%

Prenatal and Postpartum Care (PPC) Timeliness of Prenatal Care

60.00%

62.50%

90.40%

Prenatal and Postpartum Care (PPC) Postpartum Care

54.00%

79.17%

89.20%

Proportion of Days Covered (PDC) RAS Antagonists

69.09%

70.51%

83.50%

Proportion of Days Covered (PDC) Diabetes All Class

64.51%

67.89%

79.60%

Proportion of Days Covered (PDC) Statins

64.48%

62.06%

81.30%

Use of Imaging Studies for Low Back Pain (LBP)

72.31%

67.47%

79.10%

Well-Child Visits in the First 30 Months of Life (W30) Well-Child Visits in the First 15 Months

NA

NA

86.19%

Well-Child Visits in the First 30 Months of Life (W30) Well-Child Visits for Age 15 Months – 30 Months

NA

NA

88.90%

Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (WCC)

BMI Percentile Total

85.62%

84.58%

87.16%

Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (WCC)

Counseling for Nutrition Total

82.03%

79.74%

80.40%

Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (WCC)

Counseling for Physical Activity Total

79.41%

79.30%

77.44%

Child and Adolescent Well-Care Visits (WCV) Total

57.00%

59.95%

59.50%

Molina Healthcare of Florida 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.

* Not Reported in 2022

NA = Not Available

NB = No Benefit

NR = Not Reported

NQ = Not Required

BR = Biased Rate

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