CY 2019 MMA Performance Measure Scores Health Plans

CY 2019 MMA Performance Measure ScoresHEDIS, Core Set, and Agency-defined measures

Aetna Better

Health

Children's

Medical

Services Clear Health

Community

Care Plan

Florida

Community

Care Humana

Measure

SourceAdults' Access to Preventive/Ambulatory

Health Services - ages 20-44 64% N/A 82% 61% ** 70% HEDIS

Adults' Access to Preventive/Ambulatory

Health Services - ages 45-64 80% N/A 93% 81% 91% 87% HEDIS


Health Services - ages 65+ 86% N/A 92% 86% 91% 90% HEDIS


Health Services -Total 71% N/A 89% 69% 91% 80% HEDIS

Chlamydia Screening in Women - Total 70% 49% 85% 68% ** 67% HEDIS

Comprehensive Diabetes Care - HbA1C Good

Control 52% 29% 44% 55% 0% 52% HEDIS

Comprehensive Diabetes Care - Eye Exam 54% 45% 39% 66% ** 59% HEDIS

Comprehensive Diabetes Care - Nephropathy 94% 86% 94% 95% 84% 91% HEDIS

Lead Screening in Children 78% 72% ** 81% ** 72% HEDIS

Medication Management for People with

Asthma - 75% Medication Compliance - Total 28% 37% 53% 26% ** 33% HEDIS

Health Plans

Performance Measures

** = Insufficient enrollment to report this measure 1 of 21 N/A = Not a required measure for this plan


Aetna Better

Health

Children's

Medical


Community

Care Plan

Florida

Community

Care Humana

Measure

Source

Health Plans

Performance MeasuresMetabolic Monitoring for Children and

Adolescents on Antipsychotics - 1-17- Total-

Blood Gluclose and Cholesterol Testing 44% 40% ** 51% ** 38% HEDIS

Adherence to Antipsychotic Medications for

Individuals with Schizophrenia 58% 65% 50% 61% 88% 64%HEDIS, Adult

Core Set

Adult BMI Assessment 97% 74% 95% 97% ** 94%HEDIS, Adult

Core Set

Antidepressant Medication Management -

Effective Acute Phase Treatment 51% 70% 56% 53% ** 56%HEDIS, Adult

Core Set


Effective Continuation Phase Treatment 40% 59% 41% 45% ** 40%HEDIS, Adult

Core Set

Asthma Medication Ratio- 5-11 years 91% 85% ** 75% ** 75% HEDIS

Asthma Medication Ratio- 12-18 years 79% 76% ** 67% ** 75% HEDIS

Asthma Medication Ratio- 19-50 years 51% ** 39% 65% ** 63% HEDIS

Asthma Medication Ratio- 51-64 years 51% ** 31% ** ** 58% HEDIS



Aetna Better

Health

Children's

Medical


Community

Care Plan

Florida

Community

Care Humana

Measure

Source

Health Plans


Asthma Medication Ratio- Total 79% 82% 34% 70% ** 71% HEDIS

Breast Cancer Screening 68% N/A 54% 66% ** 61%HEDIS, Adult

Core Set

Cervical Cancer Screening 67% N/A 69% 63% 3% 60%HEDIS, Adult

Core Set

Chlamydia Screening in Women - 21-24 years 73% ** 90% 71% ** 70%HEDIS, Adult

Core Set

Comprehensive Diabetes Care - HbA1C

Testing 89% 90% 83% 90% 67% 89%HEDIS, Adult

Core Set

Controlling High Blood Pressure 72% 61% 64% 68% ** 75%HEDIS, Adult

Core Set

Diabetes Screening for People with

Schizophrenia or Bipolar Disorder Who Are

Using Antipsychotic Medications 82% ** 98% 86% ** 85%HEDIS, Adult

Core Set

Engagement of Alcohol and Other Drug

Dependence Treatment - Total 5% 12% 5% 7% ** 5%HEDIS, Adult

Core Set

Follow-up After Emergency Department Visit

for Alcohol and Other Drug Dependence - 7

Day - Total 5% 2% 5% 3% ** 4%HEDIS, Adult

Core Set



Aetna Better

Health

Children's

Medical


Community

Care Plan

Florida

Community

Care Humana

Measure

Source

Health Plans

Performance MeasuresInitation of Alcohol and Other Drug

Dependence Treatment - Total 39% 54% 47% 37% ** 42%HEDIS, Adult

Core Set



Day - Total 8% 2% 9% 9% ** 8%HEDIS, Adult

Core Set


for Mental Illness - 7 Day 26% 41% 30% 30% ** 27%HEDIS, Adult

Core Set


for Mental Illness - 30 Day 48% 60% 43% 38% ** 44%HEDIS, Adult

Core Set

Plan All-Cause Readmissions - ages 18-64

years - Total 12% N/A 13% 10% ** 14%HEDIS, Adult

Core Set

Timeliness of Prenatal Care 95% 91% 79% 91% ** 91%HEDIS, Adult

Core Set

Postpartum Care 82% 68% 63% 80% ** 74%HEDIS, Adult

Core Set

Comprehensive Diabetes Care - HbA1C Poor

Control (INVERSE) 41% 60% 48% 34% 97% 38%HEDIS, Adult

Core Set

Adolescent Well-Care Visits 64% 77% 55% 63% ** 63%HEDIS, Child

Core Set

Childhood Immunization Status -

Combination 2 84% 80% ** 79% ** 75%HEDIS, Child

Core Set



Aetna Better

Health

Children's

Medical


Community

Care Plan

Florida

Community

Care Humana

Measure

Source

Health Plans

Performance MeasuresChildhood Immunization Status -

Combination 3 80% 74% ** 76% ** 71%HEDIS, Child

Core Set

Children and Adolescents' Access to Primary

Care Practitioners - ages 12-24 months 95% 99% ** 95% ** 93%HEDIS, Child

Core Set


Care Practitioners - ages 25 months - 6 years 89% 95% 66% 91% ** 86%HEDIS, Child

Core Set


Care Practitioners - ages 7-11 years 93% 97% ** 92% ** 89%HEDIS, Child

Core Set


Care Practitioners - ages 12-19 years 89% 96% ** 87% ** 87%HEDIS, Child

Core Set

Chlamydia Screening in Women - 16-20 years 69% 49% ** 68% ** 66%HEDIS, Child

Core Set

Follow-up Care for Children Prescribed ADHD

Medication - Initiation Phase 49% 51% ** 36% ** 39%HEDIS, Child

Core Set


Medication - Continuation and Maintenance

Phase ** 53% ** 56% ** 57%HEDIS, Child

Core Set



Aetna Better

Health

Children's

Medical


Community

Care Plan

Florida

Community

Care Humana

Measure

Source

Health Plans


Follow-up After Hospitalization for Mental

Illesss- 7 Day 37% 42% 8% 36% 12% 37% HEDIS


Illesss- 30 Day 58% 67% 13% 55% 37% 57% HEDIS

Immunization for Adolescents - Combination

1 79% 77% ** 81% ** 77%HEDIS, Child

Core Set

Use of First-Line Psychosocial Care for

Children and Adolescents on Antipsychotics -

Total 78% 45% ** 43% ** 61%HEDIS, Child

Core Set

Well-Child Visits in the First 15 Months of Life

- 6+ Visits 81% 55% ** 77% ** 73%HEDIS, Child

Core Set

Well-Child Visits in the Third, Fourth, Fifth,

and Sixth Years of Life 82% 85% 60% 82% ** 81%HEDIS, Child

Core Set

Well-Child Visits in the First 15 Months of Life

- 0 Visits (INVERSE) 1% 0% ** 1% ** 2%HEDIS, Child

Core Set

HIV Viral Load Suppression - ages 18-64 years 11% 0% 18% 44% ** 27% Adult Core Set

HIV Viral Load Suppression - ages 65+ years ** N/A 18% ** ** 17% Adult Core Set

Mental Health Readmission Rate (INVERSE) 21% 25% 43% 21% 45% 28%Agency-

defined



Aetna Better

Health

Children's

Medical


Community

Care Plan

Florida

Community

Care Humana

Measure

Source

Health Plans




Lighthouse Magellan

Miami

Children Molina Prestige Simply

Measure

SourceAdults' Access to Preventive/Ambulatory

Health Services - ages 20-44 55% 71% 42% 74% 68% 70% HEDIS


Health Services - ages 45-64 71% 83% 58% 88% 83% 87% HEDIS


Health Services - ages 65+ ** 87% 74% 92% 84% 93% HEDIS


Health Services -Total 60% 75% 48% 81% 73% 79% HEDIS

Chlamydia Screening in Women - Total 51% 62% 72% 68% 73% 61% HEDIS

Comprehensive Diabetes - HbA1C Good Control 35% 37% 22% 57% 44% 58% HEDIS

Comprehensive Diabetes - Eye Exam 13% 28% 6% 65% 56% 58% HEDIS

Comprehensive Diabetes - Nephropathy 92% 90% 87% 95% 94% 93% HEDIS

Lead Screening in Children 58% ** 59% 74% 83% 76% HEDIS


Asthma - 75% Medication Compliance - Total ** 49% ** 33% 29% 33% HEDIS


Health Plans



Lighthouse Magellan

Miami


Measure

SourcePerformance Measures

Health Plans

Metabolic Monitoring for Children and

Adolescents on Antipsychotics - Total 19% 35% ** 45% 58% 34% HEDIS


Individuals with Schizophrenia ** 58% ** 64% 64% 66%HEDIS, Adult

Core Set

Adult BMI Assessment ** 90% ** 97% 89% 93%HEDIS, Adult

Core Set


Effective Acute Phase Treatment ** 49% ** 60% 50% 59%HEDIS, Adult

Core Set


Effective Continuation Phase Treatment ** 37% ** 42% 33% 44%HEDIS, Adult

Core Set

Asthma Medication Ratio- 5-11 years ** ** ** 88% 91% 85% HEDIS

Asthma Medication Ratio- 12-18 years ** 58% ** 80% 64% 75% HEDIS

Asthma Medication Ratio- 19-50 years ** 46% ** 68% 55% 60% HEDIS

Asthma Medication Ratio- 51-64 years ** 54% ** 71% ** 59% HEDIS



Lighthouse Magellan

Miami


Measure


Health Plans

Asthma Medication Ratio- Total ** 51% ** 82% 76% 77% HEDIS

Breast Cancer Screening ** 43% ** 69% 61% 66%HEDIS, Adult

Core Set

Cervical Cancer Screening 28% 49% 20% 63% 58% 66%HEDIS, Adult

Core Set

Chlamydia Screening in Women - 21-24 years 62% 67% 60% 71% 73% 67%HEDIS, Adult

Core Set

Comprehensive Diabetes - HbA1C Testing 86% 84% 79% 92% 88% 89%HEDIS, Adult

Core Set

Controlling Blood Pressure - Total 51% 54% 53% 72% 60% 71%HEDIS, Adult

Core Set



Using Antipsychotic Medications 90% 72% ** 86% 85% 83%HEDIS, Adult

Core Set


Dependence Treatment - Total 6% 7% 6% 7% 3% 5%HEDIS, Adult

Core Set


for Alcohol and Other Drug Dependence - 7 Day -

Total 14% 6% ** 6% 11% 5%HEDIS, Adult

Core Set



Lighthouse Magellan

Miami


Measure


Health Plans

Initation of Alcohol and Other Drug


Core Set



Day - Total 21% 8% ** 9% 14% 8%HEDIS, Adult

Core Set


for Mental Illness - 7 Day 26% 29% 42% 22% 25% 34%HEDIS, Adult

Core Set


for Mental Illness - 30 Day 41% 48% 71% 47% 43% 50%HEDIS, Adult

Core Set

Plan All-Cause Readmissions - ages 18-64 years -

Total ** 15% ** 10% 11% 10%HEDIS, Adult

Core Set

Timeliness of Prenatal Care 90% 74% 79% 99% 97% 91%HEDIS, Adult

Core Set

Postpartum Care 74% 51% 66% 77% 83% 77%HEDIS, Adult

Core Set

Comprehensive Diabetes - HbA1C Poor Control

(INVERSE) 61% 58% 70% 34% 46% 32%HEDIS, Adult

Core Set

Adolescent Well Care Visits 50% 43% 60% 66% 69% 66%HEDIS, Child

Core Set

Childhood Immunization Status - Combination 2 67% ** 58% 84% 80% 82%HEDIS, Child

Core Set



Lighthouse Magellan

Miami


Measure


Health Plans

Childhood Immunization Status - Combination 3 67% ** 56% 82% 76% 79%HEDIS, Child

Core Set


Care Practitioners - ages 12-24 months 94% ** 92% 97% 96% 97%HEDIS, Child

Core Set


Care Practitioners - ages 25 months - 6 years 82% ** 87% 92% 93% 92%HEDIS, Child

Core Set


Care Practitioners - ages 7-11 years ** 71% ** 93% 92% 93%HEDIS, Child

Core Set


Care Practitioners - ages 12-19 years ** 69% ** 90% 90% 89%HEDIS, Child

Core Set

Chlamydia Screening in Women - 16-20 years 47% 60% 74% 67% 73% 59%HEDIS, Child

Core Set


Medication - Initiation Phase ** 22% ** 46% 36% 44%HEDIS, Child

Core Set



Phase ** ** ** 63% 48% 58%HEDIS, Child

Core Set



Lighthouse Magellan

Miami


Measure


Health Plans


Illness-7 Day 0% 20% 1% 39% 31% 15% HEDIS



Immunization for Adolescents - Combination 1 ** 50% 56% 78% 82% 80%HEDIS, Child

Core Set

Use of First-Line Psychosocial Care for Children

and Adolescents on Antipsychotics - Total ** 68% ** 77% 78% 66%HEDIS, Child

Core Set

Well-Child Visits in the First 15 Months of Life -

6+ Visits ** ** ** 79% 72% 77%HEDIS, Child

Core Set

Well-Child Visits in the Third, Fourth, Fifth, and

Sixth Years of Life 71% ** 75% 84% 85% 79%HEDIS, Child

Core Set


0 Visits (INVERSE) ** ** ** 1% 1% 1%HEDIS, Child

Core Set

HIV Viral Load Suppression - ages 18-64 years ** 0% ** ** 0% 18% Adult Core Set

HIV Viral Load Suppression - ages 65+ years ** ** ** ** ** 18% Adult Core Set

Mental Health Readmission Rate (INVERSE) 0% 37% 0% 23% 21% 21%Agency-

defined



Lighthouse Magellan

Miami


Measure


Health Plans



Staywell

Staywell-

SMI Sunshine

Sunshine -

Child Welfare United Vivida Measure SourceAdults' Access to Preventive/Ambulatory

Health Services - ages 20-44 73% 78% 63% N/A 70% 56% HEDIS


Health Services - ages 45-64 87% 87% 80% N/A 87% 69% HEDIS


Health Services - ages 65+ 86% 79% 77% N/A 84% 81% HEDIS


Health Services -Total 79% 81% 69% N/A 78% 62% HEDIS

Chlamydia Screening in Women - Total 64% 66% 67% 71% 62% 55% HEDIS

Comprehensive Diabetes - HbA1C Good Control 45% 38% 46% ** 54% 39% HEDIS

Comprehensive Diabetes - Eye Exam 57% 47% 61% ** 57% 13% HEDIS

Comprehensive Diabetes - Nephropathy 90% 93% 91% ** 93% 92% HEDIS

Lead Screening in Children 77% ** 72% 75% 73% 56% HEDIS


Asthma - 75% Medication Compliance - Total 34% ** 30% 36% 32% ** HEDIS

Health Plans




Staywell

Staywell-

SMI Sunshine

Sunshine -

Child Welfare United Vivida Measure Source

Health Plans


Metabolic Monitoring for Children and

Adolescents on Antipsychotics - Total 35% 36% 36% 46% 39% ** HEDIS


Individuals with Schizophrenia 58% 55% 70% ** 65% **HEDIS, Adult

Core Set

Adult BMI Assessment 93% 90% 89% ** 93% **HEDIS, Adult

Core Set


Effective Acute Phase Treatment 52% 54% 49% 65% 59% **HEDIS, Adult

Core Set


Effective Continuation Phase Treatment 37% 39% 35% 32% 44% **HEDIS, Adult

Core Set

Asthma Medication Ratio- 5-11 years 83% 80% 78% 84% 82% ** HEDIS

Asthma Medication Ratio- 12-18 years 77% 69% 69% 72% 72% ** HEDIS

Asthma Medication Ratio- 19-50 years 58% 47% 61% ** 56% ** HEDIS

Asthma Medication Ratio- 51-64 years 57% ** 59% ** 56% ** HEDIS



Staywell

Staywell-

SMI Sunshine

Sunshine -


Health Plans


Asthma Medication Ratio- Total 76% 62% 72% 80% 71% ** HEDIS

Breast Cancer Screening 60% 57% 59% N/A 57% **HEDIS, Adult

Core Set

Cervical Cancer Screening 63% 39% 54% N/A 62% 37%HEDIS, Adult

Core Set

Chlamydia Screening in Women - 21-24 years 69% 68% 71% ** 67% **HEDIS, Adult

Core Set

Comprehensive Diabetes - HbA1C Testing 84% 84% 87% ** 86% 92%HEDIS, Adult

Core Set

Controlling Blood Pressure - Total 62% 59% 63% ** 66% 60%HEDIS, Adult

Core Set



Using Antipsychotic Medications 79% 77% 83% 75% 82% **HEDIS, Adult

Core Set



Core Set



Day - Total 6% 8% 5% 1% 8% **HEDIS, Adult

Core Set



Staywell

Staywell-

SMI Sunshine

Sunshine -


Health Plans

Performance MeasuresInitation of Alcohol and Other Drug


Core Set



Day - Total 10% 11% 6% 4% 12% **HEDIS, Adult

Core Set


for Mental Illness - 7 Day 25% 23% 25% 52% 26% **HEDIS, Adult

Core Set


for Mental Illness - 30 Day 40% 37% 39% 65% 41% **HEDIS, Adult

Core Set

Plan All-Cause Readmissions - ages 18-64 years -

Total 11% 20% 12% N/A 9% **HEDIS, Adult

Core Set

Timeliness of Prenatal Care 94% 86% 91% 86% 89% 78%HEDIS, Adult

Core Set

Postpartum Care 76% 66% 73% 68% 73% 71%HEDIS, Adult

Core Set

Comprehensive Diabetes - HbA1C Poor Control

(INVERSE) 47% 54% 47% ** 37% 54%HEDIS, Adult

Core Set

Adolescent Well Care Visits 65% 55% 58% 66% 58% 51%HEDIS, Child Core

Set

Childhood Immunization Status - Combination

2 78% ** 77% 84% 77% 63%HEDIS, Child Core

Set



Staywell

Staywell-

SMI Sunshine

Sunshine -


Health Plans

Performance MeasuresChildhood Immunization Status - Combination

3 73% ** 71% 78% 73% 56%HEDIS, Child Core

Set


Care Practitioners - ages 12-24 months 96% ** 92% 98% 94% 91%HEDIS, Child Core

Set


Care Practitioners - ages 25 months - 6 years 90% 92% 85% 90% 85% 83%HEDIS, Child Core

Set


Care Practitioners - ages 7-11 years 90% 95% 85% 87% 86% **HEDIS, Child Core

Set


Care Practitioners - ages 12-19 years 88% 93% 81% 83% 83% **HEDIS, Child Core

Set

Chlamydia Screening in Women - 16-20 years 62% 65% 66% 71% 60% 48%HEDIS, Child Core

Set


Medication - Initiation Phase 46% 58% 45% 48% 46% **HEDIS, Child Core

Set



Phase 63% ** 63% 58% 62% **HEDIS, Child Core

Set



Staywell

Staywell-

SMI Sunshine

Sunshine -


Health Plans






Immunization for Adolescents - Combination 1 74% 73% 72% 78% 71% 53%HEDIS, Child Core

Set

Use of First-Line Psychosocial Care for Children

and Adolescents on Antipsychotics - Total 66% 61% 67% 73% 55% **HEDIS, Child Core

Set


6+ Visits 72% ** 67% 62% 73% **HEDIS, Child Core

Set

Well-Child Visits in the Third, Fourth, Fifth, and

Sixth Years of Life 80% 79% 78% 86% 74% 72%HEDIS, Child Core

Set


0 Visits (INVERSE) 1% ** 5% 1% 1% **HEDIS, Child Core

Set

HIV Viral Load Suppression - ages 18-64 years 0% 0% 14% ** 40% ** Adult Core Set

HIV Viral Load Suppression - ages 65+ years 0% ** 13% N/A 18% 0% Adult Core Set

Mental Health Readmission Rate (INVERSE) 27% 32% 23% 34% 19% 0% Agency-defined



Staywell

Staywell-

SMI Sunshine

Sunshine -


Health Plans



Documents

CY 2019 MMA Performance Measure Scores Health Plans