CenCal Health rates in the top ten percent of Medicaid plans nationwide for 17 of 21 clinical quality of care measures. Of those, CenCal Health was in the top five percent for eight of the indicators. This year’s overall results mark the best performance that CenCal Health and its network of physicians have achieved since CenCal Health began annual reporting in 2000.
Indicators scoring highly include several components of diabetes care, such as hemoglobin A1c (average blood glucose) control and timely retinal eye exams. High scores in these areas are important because people with poorly controlled diabetes are at higher risk for lower-limb amputation and diabetic retinopathy, an eye disease that affects eight million Americans with diabetes and the leading cause of blindness. Over the last two years, eye exam screenings for diabetic members in San Luis Obispo County have improved thirteen percentage points. In Santa Barbara County, the percentage of diabetic members who had a poorly controlled hemoglobin A1c test rated among the best five percent in the nation.
“These outstanding results are directly attributable to the dedication of our physician network,” said Dr. Takashi Wada, Chief Medical Officer at CenCal Health. “The unique collaboration between CenCal Health and our physicians continues to deliver year-over-year improvements in the quality of care provided to Medi-Cal members in our community.”
CenCal Health also scored high marks in delivering maternity care and education to new mothers. Timely and appropriate maternity care can prevent complications that can affect the health of mother and baby. About ninety percent of CenCal Health’s pregnant mothers receive timely prenatal care, according to the results. Results in Santa Barbara rated among the highest of Medicaid plans for timely postpartum care, an important check-up to address any adverse effects of childbirth, including emotional changes like postpartum depression.
Additional measures that rate in the top five percent include: Counseling to help children and adolescents maintain healthy weight, adolescent immunizations, and hemoglobin A1c not poorly controlled for patients with diabetes. Other measures that also rated in the top ten percent include blood pressure control for diabetic members, pediatric well-care exams, counseling to help children and adolescents maintain healthy weight, avoidance of imaging studies for low back pain, and high blood pressure control.
Health plans report results annually as part of a set of standardized performance measures called HEDIS®, which allows consumers to compare health care quality among plans nationally.
If you would like to learn more about CenCal Health’s services, please visit CenCal Health’s website at www.cencalhealth.org or call (800) 421-2560. Detailed performance results are available on the CenCal Health website at www.cencalhealth.org/providers/quality-of-care/hedis.
The Healthcare Effectiveness Data and Information Set (HEDIS®) is a tool used by the California Department of Health Care Services, CenCal Health, and more than ninety percent of America’s health plans to measure performance for important aspects of care such as preventive health screenings. HEDIS is a set of standardized performance measures designed to ensure that purchasers and consumers have the information they need to reliably compare health care quality.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA). NCQA is a private, non-profit organization dedicated to improving health care quality. It accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. For more information about HEDIS and NCQA, please refer to NCQA’s Web site, www.ncqa.org.
About CenCal Health
CenCal Health provides health insurance for approximately twenty percent of residents in Santa Barbara and San Luis Obispo counties, or nearly 180,000 members, enrolled in Medi-Cal, California’s version of the Medicaid program. CenCal Health coverage is accepted by the vast majority of local health care providers. CenCal Health has served the community for nearly 35 years, and provides education and assistance to its members in order to reduce potential health problems from chronic illness such as diabetes and asthma. For more information, visit www.cencalhealth.org or find CenCal Health on Facebook.