HEDIS® 2009 for California
Molina values the care and service, health education and advice our providers give to our members. Our HEDIS® (Healthcare Effectiveness Data and Information Set) and quality improvement programs and initiatives represent a collaborative effort between our providers and Molina to improve overall healthcare. Together, we can make a difference in our member's health outcomes.
Molina Healthcare of California participates in annual HEDIS® (Healthcare Effectiveness Data and Information Set) data collection that is used for California MediCal and Healthy Families quality reporting and voluntary NCQA (National Committee for Quality Assurance) accreditation process. The 2009 HEDIS® scores are based on the care members received through the end of 2008. Molina's goal is to reach the 90th percentile nationally based on NCQA (National Committee for Quality Assurance) Medicaid benchmarks for quality care.
2009 HEDIS scores for each service area are posted below:
Measures of care that met the NCQA 75th or 90th percentile for each product line included:
San Bernardino/Riverside Medicaid HEDIS results
- Well Child Care first 15 months of care 5 visits (90th percentile)
- Well Child Care age 3-6: (75th percentile)
- Adolescent Well Care: (75th percentile)
San Bernadino/Riverside measures with improvement included: Childhood immunizations, URI treatment, cervical cancer screenings, appropriate medication for asthma.
Sacramento Medicaid HEDIS results
Well Child Care age 3-6: (75th percentile)
Adolescent Well Care: (75th percentile)
URI Treatment: (90th percentile)
Chlamydia Screenings for women age 16-20: (90th percentile)
Appropriate Medical for Asthma 18-56: (90th percentile)
Sacramento measures with improvement included: Well Child Care first 15 months six or more visits, appropriate testing pharyngitis, controlling high blood pressure, monitoring for neoropathy and HbA1c testing for diabetics.
San Diego Medicaid HEDIS results
San Diego measures with improvement included: Appropriate testing for pharyngitis, cervical cancer screenings, chlamydia screening age 16-20, timeless of postpartum care, appropriate medication asthma.
Healthy Families Preventive Health Care
Well Child Care age 3-6: (75th percentile)
Adolescent Well Care: (75th percentile)
URI Treatment: (75th percentile)
We will continue to offer programs to assist our providers and members to improve healthcare outcomes by encouraging annual wellness visits and the use of our disease management programs. We offer member incentives for these programs.
Examples of initiatives to assist in improving our HEDIS rates are:
- Provider missed services quarterly reporting
- Member missed services outreach reminder calls
- Provider Partnership programs
- Practitioner and member newsletters
- Multi-language translations for targeted Health Education and wellness mailings and disease management programs
Disease Management Program incentives for:
- Pediatric and adult asthma disease management - breathe with easesm
- Adult diabetes disease management - Healthy Living with Diabetessm
- motherhood matterssm program for pregnancy care that emphasizes timely prenatal and postpartum visits
For information about the disease management and other wellness programs, call (800) 526-8196 ext. 127532
If you have any questions, would like additional information about HEDIS®, or have suggestions for our Quality Improvement Program, please call 1-800-526-8196, Ext. 126137.
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