HEDIS

HEDIScontactThe 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 seven aspects of care and in the top 10% for an additional seven. This marks another great performance by providers in delivering excellent service to our members.

ComplianceAuditlogo2019CenCal Health thanks all providers for their support during the HEDIS® 2019 quality of care evaluation.

Below are the most recent results:

2019 HEDIS Results

2018 HEDIS Results

Santa Barbara County Results

Quality of care excellence was achieved for:

  • Diabetic Eye Exams
  • A1c Control < 8%
  • A1c Poor Control (fewer diabetic members with A1c >9%)
  • Adolescent Immunizations (Tdap/Meningococcal/HPV)
  • Nutrition Counseling for Children and Adolescents
  • Physical Activity Counseling for Children and Adolescents
  • Timeliness of Prenatal Care
  • Timeliness of Postpartum Care

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)


San Luis Obispo County Results

Quality of care excellence was achieved for:

  • Diabetic Eye Exams
  • A1c Control < 8%
  • A1c Poor Control (fewer diabetic members with A1c >9%)
  • Nutrition Counseling for Children and Adolescents
  • Physical Activity Counseling for Children and Adolescents
  • Timeliness of Prenatal Care

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)