Health Plan Profile
Universal Health Care
Medicaid Reform HMO


Accreditation Status: NCQA - Full
Available in Counties: Baker, Clay, Broward, Duval, Nassau

2009 Performance Measure Data Submissions for Medicaid Reform

Key Map:

Diamond means Not Measurable / Small Population- Not Measurable/Small Population Triangle means Not Reported - Not Reported Square means Not Applicable / Not Available - Not Applicable/Not Available
One Check- Three checkmarks represent the highest rank and one checkmark represents the lowest rank.


Quality of Care Indicators
Rating 
Adolescent Well Care
Two checks Out of Three Possible Checks
Adult BMI Assessment
Diamond means Not Measurable / Small Population
Adults' Access to Preventive/ Ambulatory Health Services - ages 20-44
One Check
Adults' Access to Preventive/ Ambulatory Health Services - ages 45-64
One Check
Adults' Access to Preventive/ Ambulatory Health Services - ages 65+
Diamond means Not Measurable / Small Population
Adults' Access to Preventive/ Ambulatory Health Services - Total
One Check
Annual Dental Visits - Total
One Check
Antidepressant Medication Management - Effective Acute Phase Treatment
Diamond means Not Measurable / Small Population
Antidepressant Medication Management - Effective Continuation Phase Treatment
Diamond means Not Measurable / Small Population
Breast Cancer Screening
Diamond means Not Measurable / Small Population
Cervical Cancer Screening
Two checks Out of Three Possible Checks
Childhood Immunization Status - Combination 2
Diamond means Not Measurable / Small Population
Childhood Immunization Status - Combination 3
Diamond means Not Measurable / Small Population
Comprehensive Diabetes - Eye Exam
Two checks Out of Three Possible Checks
Comprehensive Diabetes - Good Control
Two checks Out of Three Possible Checks
Comprehensive Diabetes - HbA1C Poor Control (Inverse Measure)
Two checks Out of Three Possible Checks
Comprehensive Diabetes - HbA1C Testing
Two checks Out of Three Possible Checks
Comprehensive Diabetes - LDL Screening
Two checks Out of Three Possible Checks
Comprehensive Diabetes - LDL-C Control
Two checks Out of Three Possible Checks
Comprehensive Diabetes - Nephropathy
Two checks Out of Three Possible Checks
Controlling Blood Pressure - Total
Two checks Out of Three Possible Checks
Follow-Up after Hospitalization for Mental Illness - 7 Day
One Check
Follow-Up after Hospitalization for Mental Illness - 30 Day
One Check
Follow-Up Care for Children Prescribed ADHD Medication - Continuation and Maintenance
Diamond means Not Measurable / Small Population
Follow-Up Care for Children Prescribed ADHD Medication - Initiation Phase
Diamond means Not Measurable / Small Population
Frequency of HIV Disease Monitoring Lab Tests - CD4
Two checks Out of Three Possible Checks
Frequency of HIV Disease Monitoring Lab Tests - VL
Two checks Out of Three Possible Checks
Highly Active Anti-Retroviral Treatment
Two checks Out of Three Possible Checks
Immunization for Adolescents - Combination 1
Diamond means Not Measurable / Small Population
Lead Screening in Children
Diamond means Not Measurable / Small Population
Lipid Profile Annually
Two checks Out of Three Possible Checks
Persistence of Beta-Blocker Treatment After a Heart Attack
Diamond means Not Measurable / Small Population
Prenatal Care
Two checks Out of Three Possible Checks
Prenatal Care Frequency - Greater than 81% of Visits
Two checks Out of Three Possible Checks
Postpartum Care
Two checks Out of Three Possible Checks
Readmission Rate (Inverse Measure)
One Check
Use of Angiotensin-Converting Enzyme (ACE) Inhibitors/ Angiotensin Receptor Blockers (ARB) Therapy
Two checks Out of Three Possible Checks
Use of Appropriate Medications for People with Asthma - Total
Diamond means Not Measurable / Small Population
Well-Child 0 Visits (Inverse Measure)
One Check
Well-Child 6+ Visits
Two checks Out of Three Possible Checks
Well-Child Visits in the 3rd, 4th, 5th, & 6th Years of Life
One Check

2008 Performance Measure Data Submissions for Medicaid Reform

Key Map:

Diamond means Not Measurable / Small Population- Not Measurable/Small Population Triangle means Not Reported - Not Reported Square means Not Applicable / Not Available - Not Applicable/Not Available
One Check- Three checkmarks represent the highest rank and one checkmark represents the lowest rank.

 
Quality of Care Indicators:
Rating
Adults' Access to Preventive/Ambulatory Health Services
One Check Out of Three Possible Checks
Use of Angiotensin-Converting Enzyme (ACE) Inhibitors/Angiotensin Receptor Blockers (ARB) Therapy
Diamond means Not Measurable / Small Population
Annual Dental Visits - Total
One Check Out of Three Possible Checks
Antidepressant Medication Management - Effective Acute Phase Treatment
Diamond means Not Measurable / Small Population
Antidepressant Medication Management - Effective Continuation Phase Treatment
Diamond means Not Measurable / Small Population
Use of Appropriate Medications for People with Asthma - Total
Diamond means Not Measurable / Small Population
Use of Appropriate Medications for People with Asthma in DM - Total
Diamond means Not Measurable / Small Population
Adolescent Well Care
Diamond means Not Measurable / Small Population
Breast Cancer Screening
Diamond means Not Measurable / Small Population
Controlling Blood Pressure - Total
Diamond means Not Measurable / Small Population
Cervical Cancer Screening
One Check Out of Three Possible Checks
Comprehensive Diabetes - HbA1C Testing
Diamond means Not Measurable / Small Population
Comprehensive Diabetes - HbA1C Poor Control (Inverse Measure)
Diamond means Not Measurable / Small Population
Comprehensive Diabetes - Good Control
Diamond means Not Measurable / Small Population
Comprehensive Diabetes - Eye Exam
Diamond means Not Measurable / Small Population
Comprehensive Diabetes - LDL Screening
Diamond means Not Measurable / Small Population
Comprehensive Diabetes - LDL-C Control
Diamond means Not Measurable / Small Population
Comprehensive Diabetes - Nephropathy
Diamond means Not Measurable / Small Population
Childhood Immunization Status - Combination 2
Diamond means Not Measurable / Small Population
Childhood Immunization Status - Combination 3
Diamond means Not Measurable / Small Population
Follow-Up after Hospitalization for Mental Illness - 7 Day
Diamond means Not Measurable / Small Population
Follow-Up after Hospitalization for Mental Illness - 30 Day
Diamond means Not Measurable / Small Population
Frequency of Ongoing Prenatal Care - Greater than 81% of Visits
Diamond means Not Measurable / Small Population
Lipid Profile Annually
Diamond means Not Measurable / Small Population
Lead Screening in Children
Diamond means Not Measurable / Small Population
Prenatal Care
Diamond means Not Measurable / Small Population
Postpartum Care
Diamond means Not Measurable / Small Population
Mental Health Readmission Rate
Diamond means Not Measurable / Small Population
Use of Beta Agonist
Diamond means Not Measurable / Small Population
Well-Child 0 Visits (Inverse Measure)
Diamond means Not Measurable / Small Population
Well-Child 6+ Visits
Diamond means Not Measurable / Small Population
Well-Child Visits in the 3rd, 4th, 5th, & 6th Years of Life
Diamond means Not Measurable / Small Population


2007 Performance Measure Data Submissions for Medicaid Reform

Key Map:

Diamond Means Not Measureable/Small Population Not Measurable/Small Population - Triangle Means Not Reported Not Reported - Square Means Not Applicable/Not Available Not Applicable/Not Available
One Checkmark Three checkmarks represent the highest rank and one checkmark represents the lowest rank.

 
Quality of Care Indicators:
Rating
Annual Dental Visits Three Checks Out of Three Possible Checks
Adolescent Well Care Diamond Means Not Measureable/Small Population
Controlling Blood Pressure - Total Diamond Means Not Measureable/Small Population
Cervical Cancer Screening Diamond Means Not Measureable/Small Population
Comprehensive Diabetes - HbA1C Testing Diamond Means Not Measureable/Small Population
Comprehensive Diabetes - HbA1C Poor Control (Inverse Measure) Diamond Means Not Measureable/Small Population
Comprehensive Diabetes - Good Control Diamond Means Not Measureable/Small Population
Comprehensive Diabetes - Eye Exam Diamond Means Not Measureable/Small Population
Comprehensive Diabetes - LDL Screening Diamond Means Not Measureable/Small Population
Comprehensive Diabetes - LDL-C Control Diamond Means Not Measureable/Small Population
Comprehensive Diabetes - Nephropathy Diamond Means Not Measureable/Small Population
Follow-Up after Hospitalization for Mental Illness - 7 Day Diamond Means Not Measureable/Small Population
Follow-Up after Hospitalization for Mental Illness - 30 Day Diamond Means Not Measureable/Small Population
Prenatal Care Diamond Means Not Measureable/Small Population
Postpartum Care Diamond Means Not Measureable/Small Population
Use of Beta Agonist Diamond Means Not Measureable/Small Population
Well-Child 0 Visits (Inverse Measure) Diamond Means Not Measureable/Small Population
Well-Child 6+ Visits Diamond Means Not Measureable/Small Population
Well-Child Visits in the 3rd, 4th, 5th, & 6th Years of Life Diamond Means Not Measureable/Small Population

 


For more information on Florida Medicaid Quality in Managed Care, please contact:

qualityinmc@ahca.myflorida.com




Reporting Medicaid Fraud