Medicaid MCO Performance On HEDIS Measures Lower Than Commercial Health Plan Performance

In 2013, Medicaid managed care organizations (MCOs) median performance on the 16 Healthcare Effectiveness Data and Information Set (HEDIS) measures included in the federal Medicaid Adult Core Set of 26 quality measures lagged behind commercial health plan median performance. For four measures, Medicaid MCO median performance was 10 or more percentage points lower than commercial health plan performance: Breast cancer screening was 19 points lower; follow-up after hospitalization for mental illness was 12 to 15 points lower; antidepressant medication management was 17 to 18 points lower; and post-partum care was 18 points lower. For three measures, Medicaid MCO . . .