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)

     65.01%      63.58%

64.90%

Annual Dental Visits (ADV) Total

NB

NB

54.60%

Antidepressant Medication Management (AMM) Effective Continuation Phase Treatment

45.15%

42.63%

46.74%

Appropriate Testing for Pharyngitis (CWP)

62.48%

65.69%

77.56%

Appropriate Treatment for Upper Respiratory Infection (URI) Total

92.74%

91.42%

93.08%

Asthma Medication Ratio (AMR) Total

75.34%

79.69%

69.41%

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

67.84%

65.53%

66.19%

Blood Pressure Control (<140/90) for Patients With Diabetes (BPD)       61.56%       68.61%       68.61%

Breast Cancer Screening (BCS)

61.03%

60.96%

55.25%

Cervical Cancer Screening (CCS)

63.99%

64.72%

59.85%

Childhood Immunization Status (CIS) Combination #10

42.09%

35.52%

35.04%

Chlamydia Screening in Women (CHL) Total

62.69%

62.88%

61.07%

Controlling High Blood Pressure (CBP)

64.23%

71.29%

65.45%

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

81.13%

82.27%

80.86%

 Eye Exam for Patients with Diabetes (EED)       50.85%      49.15%       56.20%

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

8.93%

19.64%

27.73%

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

37.89%

30.95%

46.35%

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

      33.50%

31.99%

41.03%

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

13.86%

18.46%

37.31%

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

50.00%

62.34%

57.90%

 Heboglobin A1c Control for Patients With Diabetes (HBD) HbA1c Control (<8%)       53.77%       53.53%       55.72%

Immunizations for Adolescents (IMA) Combination #2

46.47%

43.07%

38.93%

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

5.29%

7.54%

16.94%

 Kidney Health Evaluation for Patients With Diabetes (KED)       44.52%       43.76%       38.80%

Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM) Total

37.56%

34.67%

39.01%

Pharmacotherapy for Opioid Use Disorder (POD) Total

6.33%

10.07%

31.93%

Pharmacotherapy Management of COPD Exacerbation (PCE) Systemic Corticosteroids

69.03%

59.35%

75.79%

Pharmacotherapy Management of COPD Exacerbation (PCE) Bronchodilator

87.61%

83.74%

86.93%

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

106.31%

101.87%

≤ 92.72%

Prenatal and Postpartum Care (PPC) Timeliness of Prenatal Care

91.97%

86.37%

86.86%

Prenatal and Postpartum Care (PPC) Postpartum Care

80.78%

78.10%

80.78%

Prenatal Immunization Status (PRS) Combination Rate

7.04%

8.19%

25.81%

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

2.09%

1.95%

≤ 2.45%

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

80.48%

81.46%

81.64%

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

58.96%

54.48%

73.63%

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

75.41%

70.16%

67.07%

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

50.41%

49.10%

70.37%

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

76.24%

77.50%

63.89%

Use of Imaging Studies for Low Back Pain (LBP)

67.03%

64.30%

75.44%

Use of Opioids at High Dosage (HDO)

13.77%

10.70%

≤ 2.19%

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

0.49%

1.11%

≤ 0.870%

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

85.40%

84.91%

83.21%

 The reporting year is subsequent of the year reflected in the data; for example, “HEDIS 2023” is data collected from calendar year January-December 2022.


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