Medicaid Quality of Care

Care for People with Diabetes

Star ratings and state averages were not computed for Medicaid plans since only two plans submit HEDIS data to the state. Performance measures should be compared to the national average.

Measures were collected for people in each HMO between the ages of 18 and 75 and who have diabetes. Rates were calcualted by dividing the number of people who received the test by the total number of people with diabetes.

REMEMBER: Differences between HMOs may be caused by differences in performance OR by differences in data collection.

Eye Exam The percentage of members who had a retinal exam by an eye care professional. HMO Name Rate Data Collection Method Healthy U 63.0% Admin+Chart Review Molina 61.8% Admin+Chart Review National Average: 51.4%
Poor HbA1c Control The percentage of members who had an HbA1c level above 9.0% during their last visit. Lower numbers are better. HMO Name Rate Data Collection Method Healthy U 35.3% Admin+Chart Review Molina 40.8% Admin+Chart Review National Average: 48.7%
Hemoglobin A1c Testing (Test of Blood Sugar Level) The percentage of members who had one or more HbA1c tests. HMO Name Rate Data Collection Method Healthy U 82.5% Admin+Chart Review Molina 80.2% Admin+Chart Review National Average: 78.0%
LDL-C Level Controlled (LDL <100 mg/dL) The percentage of members who had an LDL level less than 100 mg/dl at their most recent test in the current measurement year. HMO Name Rate Data Collection Method Healthy U 43.6% Admin+Chart Review Molina 33.6% Admin+Chart Review National Average: 30.6%
LDL-C Screening Performed The percentage of members who had an LDL-C screening test performed within the current measurement year. HMO Name Rate Data Collection Method Healthy U 69.1% Admin+Chart Review Molina 66.9% Administrative National Average: 71.1%
Monitoring for Diabetic Nephropathy The percentage of members who had a kidney disease (nephropathy) screening test. HMO Name Rate Data Collection Method Healthy U 75.2% Admin+Chart Review Molina 76.0% Admin+Chart Review National Average: 74.6%