CenCal Health also highly rated for timeliness of women’s postpartum care
CenCal Health, the publicly-sponsored health plan for Medi-Cal in Santa Barbara and San Luis Obispo counties, has received top marks among the nation’s Medicaid plans for adolescent immunizations and for adolescent weight assessment according to the 2021 results from Healthcare Effectiveness Data and Information Set (HEDIS®). Santa Barbara County was rated in the top 5% nationally for meningococcal, Tdap and HPV immunizations of plan members ages 9-13. San Luis Obispo County was rated in the top 5% nationally for physical activity counseling of pediatric members, and in the top 10% of pediatric weight assessment ratings overall, including nutrition counseling and body mass index (BMI) percentiles. In addition, both counties covered by CenCal Health received the highest HEDIS rating – top 5% in the nation – for timeliness of women’s postpartum care.
“We are invested in educating and encouraging our members to engage in healthy eating and frequent physical activity, to promote overall good mental and physical health,” said Dr. Karen Hord, CenCal Health Deputy Chief Medical Officer. “For example, our new summer program – Fitness Challenge: Lompoc – will include a variety of local exploration activities with fun rewards for our young members. We also hope to expand access to our FoodRx program which aims to reduce childhood obesity and improve food insecurities for our pediatric members, by providing qualifying families with a weekly box of fresh produce.”
CenCal Health utilizes HEDIS – one of the most widely accepted performance measurement tools among managed care plans – to evaluate objectively the quality of care delivered to its members. CenCal Health then identifies whether barriers exist that may have prevented the delivery of appropriate or timely care. If barriers are identified, interventions are implemented to ensure that health plan members have future access to high-quality care.
One intervention that is credited with the high rating in adolescent immunizations is the Human Papillomavirus or HPV vaccination health initiative that CenCal Health rolled out in 2019. The two-dose vaccine program resulted in a significant increase in adolescent members of Santa Barbara County becoming fully immunized.
HEDIS is a set of standardized performance measures designed to ensure that purchasers and consumers have the reliable information they need to compare health care quality. HEDIS measurements are independently audited, and produced annually by the National Committee for Quality Assurance (NCQA) to evaluate the performance of Medicaid plans throughout the nation.
According to NCQA, each year, about four million women in the U.S. give birth, with one million women having one or more complications during pregnancy, labor and delivery or the postpartum period. Timely and adequate prenatal and postpartum care can set the stage for the long-term health and well-being of new mothers and their infants. This is the second year in a row that both counties covered by CenCal Health rated in the top 5% nationally among all Medicaid plans for timeliness of postpartum care.
“Time and again, regular preventive health care has led to improved health outcomes,” said Bob Freeman, CenCal Health CEO. “From ensuring needed vaccinations are given, to nutrition and diet counseling – preventing problems from happening in the first place offers the best result. As always, it’s our physicians that are to be commended for their commitment to the HEDIS reporting that measures these very important practices.”
Detailed performance results for the health plan are available on CenCal Health’s website. The measurement period for the 2021 report ended December 31, 2020.
About CenCal Health
CenCal Health is a community-accountable health plan that partners with over 1,500 local physicians, hospitals and other providers in delivering patient care to more than 200,000 members – about one in four residents of Santa Barbara County and one in five residents of San Luis Obispo County. A public agency, the health plan contributes approximately $50 million a month into the local economy, primarily through payments to healthcare providers who serve its membership. Established in 1983, it is the oldest managed care Medicaid plan of its kind in the nation. View its annual Community Report at cencal2020.org
About NCQA & HEDIS
NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA’s website (ncqa.org) contains information to help consumers, employers and others make more-informed health care choices. NCQA can be found online at ncqa.org, on Twitter @ncqa, on Facebook at facebook.com/NCQA.org/ and on LinkedIn at linkedin.com/company/ncqa. HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
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