CalOPTIMA
www.caloptima.org | Medicaid, HMO
-
Rank and score of 0 to 100 indicate satisfaction of surveyed members and success relative to other Medicaid plans in preventing and treating illness.
Available in: California
| Overall Score: | I |
| Satisfaction: | I |
| Prevention: |  |
| Treatment: |  |
| NCQA Accredition: | No |
How This Plan Performed (methodology)
|
Treatment
Treating chronic and acute conditions.
|
|
| Asthma |  |
|
Medicate appropriately (5-9 years old)
Appropriate drugs prescribed for asthmatic children ages 5 to 9.
|
|
|
Medicate appropriately (10-17 years old)
Appropriate drugs prescribed for asthmatic children ages 10 to 17.
|
|
|
Medicate appropriately (18-56 years old)
Appropriate drugs prescribed for asthmatic adults.
|
|
| Diabetes | |
|
Blood pressure control (130/80)
Diabetic members up to age 75 with blood pressure below 130/80 at last visit.
|
NR |
|
Blood pressure control (140/90)
Diabetic members up to age 75 with blood pressure below 140/90 at last visit.
|
NR |
|
Retinal eye exams
Eye exam given to diabetic members to age 75.
|
|
|
Glucose testing
Blood sugar level checked in diabetic members to age 75.
|
|
|
Glucose control
Blood sugar level maintained at 9 percent or below in diabetic members to age 75.
|
|
|
LDL cholesterol screening
Cholesterol checked in diabetic members to age 75.
|
|
|
LDL cholesterol control
Cholesterol level below 100 milligrams per deciliter maintained in diabetic members to age 75.
|
|
|
Monitoring kidney disease
Kidney function checked in diabetic members to age 75.
|
|
| Heart disease | I |
|
Controlling high blood pressure
Blood pressure below 140/90 at last visit in hypertensive adults to age 85.
|
NR |
|
LDL cholesterol screening
Cholesterol checked in members with heart disease.
|
NR |
|
LDL cholesterol control
Cholesterol level below 100 milligrams per deciliter maintained in adults with heart disease.
|
NR |
|
Smoking advice
Practitioners advised smokers to stop.
|
NR |
|
Stop-smoking strategies
Practitioners discussed ways to stop.
|
NR |
|
Stop-smoking medications
Practitioners discussed stop-smoking drugs.
|
NR |
| Other treatment measures | |
|
Follow-up after ADHD diagnosis
Children ages 6 to 12 newly diagnosed with attention deficit hyperactivity disorder were prescribed drugs and saw practitioner within 30 days.
|
NR |
|
Appropriate antibiotic use, adults with acute bronchitis
No immediate antibiotic for adults diagnosed with acute bronchitis.
|
|
|
Appropriate testing and care, children with pharyngitis
Antibiotic and strep test prescribed for children diagnosed with sore throat.
|
NR |
|
Monitoring key long-term medications
Adults with six-month prescriptions for certain drugs were clinically monitored.
|
NR |
|
Appropriate antibiotic use, children with URI
No immediate antibiotic for children diagnosed with common cold.
|
|