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Performance Measures

The Healthcare Effectiveness Data and Information Set (HEDIS^®) is a tool used by more than 90% of U.S. health plans to annually evaluate health plan performance on important aspects of care like preventive health screenings. HEDIS^®performance is a way to assess CenCal Health’s effectiveness as a managed care plan compared against
other health plans nationally.

Current Performance Measures
Measurement Year 2023 MCAS
Measurement Year 2024 MCAS

For additional information regarding CenCal Health’s HEDIS program, please contact: (800) 421-2560 ext. 1609.

Highlights:

CenCal Health would like to thank providers for their support during the HEDIS^® Quality of Care Compliance Audit™, which evaluated effectiveness of care, access and availability, and other important aspects of care and service.²

CenCal Health’s provider network rated among the best 5% of Medicaid plans nationally for four aspects of care, and in the top 10% for an additional five. This year’s results mark another great performance by providers to assure members received vitally important preventive services and treatment.

Findings:

Both counties surpassed high performance levels for:
- Timeliness of Postpartum Care
- HbA1c Poor Control (Lower Rate Best)
- Follow-Up After ED Visit for Alcohol & Other Drug Abuse/Dependance
In Santa Barbara County, high performance was also achieved for:
- Adolescent Immunizations (Tdap, HPV, Meningococcal)
- Well Child Exams for Ages 15 – 30 Months
- Breast Cancer Screening
In San Luis Obispo, opportunities for improvement include:
- Lead Screening for Children
- Controlling High Blood Pressure
In Santa Barbara County, opportunities for improvement include:
- Lead Screening for Children
- Controlling High Blood Pressure
- Follow-Up After ED Visit for Mental Illness

Member engagement and provider partnerships are essential to achieve improved health outcomes. Detailed practice-specific HEDIS^® Measurement Year 2022 results can be requested by contacting the Quality Measurement team, at (805) 562-1609. CenCal Health’s results are available below.

²_{NCQA HEDIS Compliance Audit™ is a trademark of the National Committee for Quality Assurance (NCQA).}