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DHHS Primary Health
Medi-Cal Managed Care Advisory Committee
February 27, 2017
HEDIS
Aggregated Quality Factor Score (AQFS)
Health Plan
Report Year 2015-2016
Change 2013 2014 2015 2016
Minimum Performance Level 40% 40% 40% 40%
Statewide Weighted Average 60% 58% 60% 60%
Anthem Blue Cross 41% 40% 43% 46% +3%
Health Net 49% 45% 50% 46% 4%
Molina 42% 41% 42% 53% +11%
Kaiser 97% 97% 97% 96% 1%
The AQFS is a single score that accounts for plan performance on all DHCS-selected Health
Effectiveness Data and Information Set (HEDIS) indicators.
Report Year data is based on the prior year’s services.
Statewide Average Plan Performance: 60%, based on weighted average.
Minimum Performance Level: 40%.
High Performance Level: 100%.
Median score: 53%.
Range: 32% (Health Net San Joaquin) to 97% (Kaiser San Diego).
Number of Health Plans: 53 (up from 44 in 2015, due to expansion into rural counties).
Five Plans are below the Minimum Performance Level:
o Centene operating as Health Net – San Joaquin – 32%
o Centene operating as California Health & Wellness – Region 1 – 38%
o Centene operating as California Health & Wellness – Region 2 – 38%
o Anthem Blue Cross – San Benito – 38%
o Health Plan of San Joaquin – San Joaquin – 39%
Source: DHCS Medi-Cal Managed Care Performance Dashboard