HEDIS® Results

Medicaid 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

Adherence to Antipsychotic Medications for Individuals with Schizophrenia (SAA)

NA

69.05%

64.90%

Annual Dental Visits (ADV)

NB

NB

54.60%

Antidepressant Medication Management (AMM) Effective Continuation Phase Treatment

22.22%

52.09%

46.74%

Appropriate Testing for Pharyngitis (CWP)

69.54%

74.26%

77.56%

Appropriate Treatment for Upper Respiratory Infection (URI)

93.49%

94.06%

93.08%

Asthma Medication Ratio (AMR) Total

59.53%

63.59%

69.41%

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

59.02%

77.33%

66.19%

Blood Pressure Control (<140/90) for Patients With Diabetes (BPD)

59.37%

54.99%

68.61%

Breast Cancer Screening (BCS)

35.66%

34.58%

55.25%

Cervical Cancer Screening (CCS)

37.23%

44.04%

59.85%

Childhood Immunization Status (CIS) Combination #10

30.66%

22.63%

35.04%

Chlamydia Screening in Women (CHL) Total

38.81%

37.39%

61.07%

Controlling High Blood Pressure (CBP)

44.77%

40.88%

65.45%

Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD)

84.62%

78.22%

80.86%

Eye Exam for Patients With Diabetes (EED)

44.77%

46.72%

56.20%

Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA) 7-Day Follow-Up Total

16.29%

NB

27.73%

Follow-Up After Emergency Department Visit for Mental Illness (FUM) 7-Day Follow-Up Total

20.12%

NB

46.35%

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

28.52%

NB

41.03%

Follow-Up After High-Intensity Care for Substance Use Disorder (FUI) 7-Day Follow-Up Total

25.30%

NB

37.31%

Follow-Up for Children Prescribed ADHD Medication (ADD) Continuation and Maintenance Phase

12.50%

NB

57.90%

Hemoglobin A1c Control for Patients With Diabetes (HBD) HbA1c Control (<8%)

38.20%

44.04%

55.72%

Immunizations for Adolescents (IMA) Combination #2

26.28%

23.11%

38.93%

Initiation and Engagement of Alcohol and Other Drug Dependence Treatment (IET) Engagement of AOD Treatment Total

NB

NB

16.94%

Kidney Health Evaluation for Patients with Diabetes (KED)

30.96%

31.80%

38.80%

Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM) Blood Glucose and Cholesterol Testing Total

NA

21.73%

39.01%

Pharmacotherapy for Opioid Use Disorder (POD) Total

14.02%

13.51%

31.93%

Pharmacotherapy Management of COPD Exacerbation (PCE) Systemic Corticosteroids

56.79%

60.71%

75.79%

Pharmacotherapy Management of COPD Exacerbation (PCE) Bronchodilator

75.31%

76.79%

86.96%

Plan All-Cause Readmissions (PCR) Observed-to-Expected Ratio 18-64 Years

102.23%

66.38%

≤ 92.72%

Prenatal and Postpartum Care (PPC) Timeliness of Prenatal Care

63.50%

76.40%

86.86%

Prenatal and Postpartum Care (PPC) Postpartum Care

65.94%

72.02%

80.78%

Prenatal Immunization Status (PRS) Combination Rate

18.10%

16.53%

25.81

Risk of Continued Opioid Use (COU) 31-Day Total

5.74%

3.97%

≤ 2.45%

Statin Therapy for Patients with Cardiovascular Disease (SPC) Received Statin Therapy Total

67.61%

70.59%

81.64%

Statin Therapy for Patients with Cardiovascular Disease (SPC) Statin Adherence 80% Total

58.33%

60.42%

73.63%

Statin Therapy for Patients with Diabetes (SPD) Received Statin Therapy

59.67%

54.98%

67.07%

Statin Therapy for Patients with Diabetes (SPD) Statin Adherence 80%

59.50%

62.99%

70.37%

Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP) Total

NA

NB

63.89%

Use of Imaging Studies for Low Back Pain (LBP)

73.96%

74.19%

75.44%

Use of Opioids at High Dosage (HDO)

7.50%

3.05%

≤ 2.19%

Use of Opioids from Multiple Providers (UOP) Multiple Prescribers and Multiple Pharmacies

1.61%

0.79%

≤ 0.87%

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

57.42%

54.99%

83.21%

 

NA = Not Available Due to Small Denominator
NB = No Benefit
NR = Not Reported
NQ = Not Required
BR = Biased Rate