HEDIS

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.

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

Highlights:

Overall, CenCal Health’s provider network rated in the top 5% among Medicaid plans nationally for eight aspects of care (an increase from two in the previous year), and in the top 10% for an additional nine. This marks the best performance that providers have ever achieved since CenCal Health first began annual reporting in 2000.

As part of ongoing improvements in quality measurement, the Quality Measurement Team is working toward collecting data through Electronic Clinical Data System (ECDS) measures. These measures allow for data sharing from Provider Electronic Medical Records to CenCal Health without the need for medical record review. If you would like to participate in the program please contact the Quality Measurement Team. 

CenCal Health thanks all providers for their support during the HEDIS® 2018 quality of care evaluation. 

Below are the most recent results. 

View the 2018 HEDIS Report

Santa Barbara County Results

In Santa Barbara County, high performance levels were achieved for: 

  • Diabetic Eye Exams
  • A1c Control < 8%
  • A1c Poor Control (fewer diabetic members with A1c >9%)
  • Diabetes Blood Pressure Control 
  • Adolescent Immunizations (Tdap/Meningococcal/HPV)
  • Nutrition Counseling for Children and Adolescents 
  • Physical Activity Counseling for Children and Adolescents
  • Well Child Exams for 3-6 years of age
  • Timeliness of Postpartum Care
  • Avoidance of Imaging Studies for Low Back Pain
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)

San Luis Obispo County Results

In San Luis Obispo County, high performance levels were achieved for: 

  • Diabetic Eye Exams
  • A1c Control < 8%
  • High Blood Pressure Control 
  • Adolescent Immunizations (Tdap/Meningococcal/HPV)
  • Nutrition Counseling for Children and Adolescents 
  • Physical Activity Counseling for Children and Adolescents
  • Well Child Exams for 3-6 years of age