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DMAS publishes key quality performance measures for our managed care programs as part of our commitment to transparency. The data below, known as the Healthcare Effectiveness Data and Information Set (HEDIS®) are nationally recognized measures that are audited for accuracy by specially certified auditors.

In alignment with the 2023-2025 DMAS Quality Strategy, the performance benchmark is the National 50th percentile, meaning that the managed care health plans must perform in the top 50% for these quality measures. 

Virginia Medicaid is committed to working toward continuous quality improvement goals to ensure that Virginia Medicaid members have timely access to quality health care. These dashboards are an important part of our effort to demonstrate the value of managed care to the Virginia Medicaid program.

It is important to note that some HEDIS® performance measure specifications are updated over time, so trending certain rates from year-to-year should be interpreted with caution and are noted as such on the dashboard. In addition, VA Medicaid also saw significant organizational and programmatic changes in this time period, including Medicaid Expansion going into effect and a few MCO mergers or acquisitions. Molina Complete Care was previously listed as Magellan, and the United Health Care plan will only display two-year trending due to reporting changes after the acquisition of INTotal Health.

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