HEDIS® Results

Medicaid HEDIS® Annual Rates.

Senior Whole Health’s scores for the past two years are below. You can see how Senior Whole Health performs compared to our target goal.

Measure

2022

2023

Goal

Adherence to Antipsychotic Medications for Individuals with Schizophrenia (SAA)

NA

NA

64.90%

Annual Dental Visits (ADV) Total

NA

NA

54.60%

Antidepressant Medication Management (AMM) Effective Continuation Phase Treatment

NA

83.33%

46.74%

Appropriate Testing for Pharyngitis (CWP)

NA

NA

77.56%

Appropriate Treatment for Upper Respiratory Infection (URI) Total

NA

NA

93.08%

Asthma Medication Ratio (AMR) Total

NA

NA

69.41%

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

NA

NA

66.19%

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

56.61%

58.62%

68.61%

Breast Cancer Screening (BCS)

62.63%

64.80%

55.25%

Cervical Cancer Screening (CCS)

NA

NA

59.85%

Childhood Immunization Status (CIS) Combination #10

NA

NA

35.04%

Chlamydia Screening in Women (CHL) Total

NA

NA

61.07%

Controlling High Blood Pressure (CBP)

47.69%

49.15%

65.45%

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

NA

NA

80.86%

Eye Exam for Patients With Diabetes (EED)

52.38%

70.11%

56.20%

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

NA

NA

27.73%

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

NA

NA

46.35%

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

NA

NA

41.03%

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

NA

NA

37.31%

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

NA

NA

57.90%

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

68.25%

58.05%

55.72%

Immunizations for Adolescents (IMA) Combination #2

NA

NA

38.93%

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

NA

NA

16.94%

Kidney Health Evaluation for Patients with Diabetes (KED)

46.04%

43.15%

38.80%

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

NA

NA

39.01%

Pharmacotherapy for Opioid Use Disorder (POD) Total

NA

NA

31.93%

Pharmacotherapy Management of COPD Exacerbation (PCE) Systemic Corticosteroids

NA

NA

75.79%

Pharmacotherapy Management of COPD Exacerbation (PCE) Bronchodilator

NA

NA

86.96%

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

NA

NA

≤ 92.72%

Prenatal and Postpartum Care (PPC) Timeliness of Prenatal Care

NA

NA

86.86%

Prenatal and Postpartum Care (PPC) Postpartum Care

NA

NA

80.78%

Prenatal Immunization Status (PRS) Combination Rate

NA

NA

25.81

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

3.33%

16.39%

≤ 2.45%

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

NA

NA

81.64%

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

NA

NA

73.63%

Statin Therapy for Patients with Diabetes (SPD)

Received Statin Therapy

90.09%

85.44%

67.07%

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

17.00%

85.23%

70.37%

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

NA

NA

63.89%

Use of Imaging Studies for Low Back Pain (LBP)

NA

NA

75.44%

Use of Opioids at High Dosage (HDO)

NA

NA

≤ 2.19%

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

0%

0%

≤ 0.87%

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

NA

NA

83.21%

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