HEDIS Information

Molina Healthcare of Florida uses the Healthcare Effectiveness Data and Information Set (HEDIS®) tool each year as a way to measure quality. This is done by looking at the type of care and services provided. HEDIS® is maintained by the National Committee for Quality Assurance (NCQA). This allows the review of certain aspects of care. This includes clinical and non-clinical care. It also shows where plans can improve care and service. Molina’s goal is to be better than 75% of other Medicaid health plans in the nation.
Molina’s scores for the past two years are below. You can see how Molina performs compared to our target goal.
Measure |
2023 Rate |
2023 Goal |
2024 Rate |
2024 Goal |
Adherence to Antipsychotic Medications for Individuals with Schizophrenia (SAA) |
63.58% |
64.90% |
66.79% |
66.15% |
Annual Dental Visits (ADV) Total |
NB |
54.60% |
|
|
Antidepressant Medication Management (AMM) Effective Continuation Phase Treatment |
42.63% |
46.74% |
39.09% |
48.16% |
Appropriate Testing for Pharyngitis (CWP) |
65.69% |
77.56% |
77.62% |
85.11% |
Appropriate Treatment for Upper Respiratory Infection (URI) Total |
91.42% |
93.08% |
89.75% |
91.27% |
Asthma Medication Ratio (AMR) Total |
79.69% |
69.41% |
79.75% |
70.56% |
Avoidance of Antibiotic Treatment for Acute Bronchitis / Bronchiolitis (AAB) |
65.53% |
66.19% |
64.55% |
67.03% |
Blood Pressure Control (<140/90) for Patients With Diabetes (BPD) |
68.61% |
68.61% |
62.04% |
71.78% |
Breast Cancer Screening (BCS) |
60.96% |
55.25% |
|
|
Breast Cancer Screening (BCS-E) |
60.58% |
54.94% |
60.13% |
56.66% |
Cervical Cancer Screening (CCS) |
64.72% |
59.85% |
62.04% |
60.10% |
Childhood Immunization Status (CIS) Combination #10 |
33.84% |
35.04% |
35.28% |
31.32% |
Chlamydia Screening in Women (CHL) Total |
62.88% |
61.07% |
65.75% |
61.46% |
Controlling High Blood Pressure (CBP) |
71.29% |
65.45% |
64.48% |
67.40% |
Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD) |
82.27% |
80.86% |
83.62% |
83.51% |
Eye Exam for Patients With Diabetes (EED) |
49.15% |
56.20% |
48.91% |
57.09% |
Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA) 7-Day Follow-Up Total |
19.64% |
27.73% |
12.14% |
27.62% |
Follow-Up After Emergency Department Visit for Mental Illness (FUM) 7-Day Follow-Up Total |
30.95% |
46.35% |
37.50% |
44.33% |
Follow-Up After Hospitalization for Mental Illness (FUH) 7-Day Follow-Up Total |
31.99% |
41.03% |
32.51% |
42.86% |
Follow-Up After High-Intensity Care for Substance Use Disorder (FUI) 7-Day Follow-Up Total |
18.46% |
37.31% |
24.07% |
37.64% |
Follow-Up for Children Prescribed ADHD Medication (ADD) Continuation and Maintenance Phase |
62.34% |
57.90% |
61.54% |
56.86% |
Follow-Up for Children Prescribed ADHD Medication (ADD-E) Continuation and Maintenance Phase |
|
|
61.54% |
56.83% |
Hemoglobin A1c Control for Patients With Diabetes (HBD) HbA1c Control (<8%) |
53.53% |
55.72% |
49.39% |
59.64% |
Immunizations for Adolescents (IMA) Combination #2 |
43.07% |
38.93% |
40.88% |
38.69% |
Initiation and Engagement of Alcohol and Other Drug Dependence Treatment (IET) Engagement of AOD Treatment Total |
7.54% |
16.94% |
7.44% |
16.78% |
Kidney Health Evaluation for Patients with Diabetes (KED) |
43.76% |
38.80% |
46.99% |
42.10% |
Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM) Blood Glucose and Cholesterol Testing Total |
34.67% |
39.01% |
39.90% |
41.92% |
Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM-E) Blood Glucose and Cholesterol Testing Total |
|
|
39.90% |
41.41% |
Pharmacotherapy for Opioid Use Disorder (POD) Total |
10.07% |
31.93% |
6.33% |
29.01% |
Pharmacotherapy Management of COPD Exacerbation (PCE) Systemic Corticosteroids |
59.35% |
75.79% |
63.48% |
74.78% |
Pharmacotherapy Management of COPD Exacerbation (PCE) Bronchodilator |
83.74% |
86.96% |
80.87% |
86.54% |
Plan All-Cause Readmissions (PCR) Observed-to-Expected Ratio 18-64 Years |
101.87% |
≤ 92.72% |
92.32% |
≤ 91.24% |
Prenatal and Postpartum Care (PPC) Timeliness of Prenatal Care |
86.37% |
86.86% |
80.05% |
86.89% |
Prenatal and Postpartum Care (PPC) Postpartum Care |
78.10% |
80.78% |
76.89% |
82.48% |
Prenatal Immunization Status (PRS) Combination Rate |
8.19% |
25.81% |
|
|
Prenatal Immunization Status (PRS-E) Combination Rate |
8.19% |
25.81% |
9.91% |
24.92% |
Risk of Continued Opioid Use (COU) 31-Day Total |
1.95% |
≤ 2.45% |
2.01% |
≤ 2.79% |
Statin Therapy for Patients with Cardiovascular Disease (SPC) Received Statin Therapy Total |
81.46% |
81.64% |
82.43% |
83.00% |
Statin Therapy for Patients with Cardiovascular Disease (SPC) Statin Adherence 80% Total |
54.48% |
73.63% |
62.70% |
74.07% |
Statin Therapy for Patients with Diabetes (SPD) Received Statin Therapy |
70.16% |
67.07% |
70.79% |
67.01% |
Statin Therapy for Patients with Diabetes (SPD) Statin Adherence 80% |
49.10% |
70.37% |
56.69% |
70.91% |
Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP) Total |
77.50% |
63.89% |
70.94% |
64.10% |
Use of Imaging Studies for Low Back Pain (LBP) |
64.30% |
75.44% |
64.61% |
72.74% |
Use of Opioids at High Dosage (HDO) |
10.70% |
≤ 2.19% |
9.88% |
≤ 2.14% |
Use of Opioids from Multiple Providers (UOP) Multiple Prescribers and Multiple Pharmacies |
1.11% |
≤ 0.87% |
1.36% |
≤ 1.22% |
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC) BMI Percentile |
84.91% |
83.21% |
88.08% |
86.20% |
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
If you have questions or would like additional information about HEDIS®, please contact Molina Healthcare of FL Quality Department at (866) 472-4585 (TTY: 711). You may request printed copies of all content posted on our website by calling the Member Services number on your member ID card.
HEDIS® is a Registered Trademark of the National Committee for Quality Assurance.