Provider materials and tools

View quality performance measures

Magellan Complete Care is supplying the following resources to help our providers in the new quality focused environment.

Quality performance measures 

Magellan Complete Care goal is to work with our providers to ensure that every member receives the very best care.  In addition, state and federal governments are demanding a healthcare industry that driven by quality.

Magellan Complete Care will monitor the following measures:

  • Diabetes monitoring for members with diabetes & schizophrenia or bi-polar disorder who are using anti-psychotic medications
  • Behavioral Health & Medical readmission rates
  • Adult access to preventive/ambulatory health services
  • Breast cancer screening
  • Cervical cancer screening
  • Use of appropriate medications for people with asthma
  • Lithium monitoring for members on Lithium

If you have any questions about any of the performance measures that Magellan Complete Care will monitor, you may contact our Network Team at (800) 424-8584.


Magellan Complete Care Florida HEDIS 2019 Results for Measurement Year 2018

The Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used set of performance measures in the managed care industry. Developed by the National Committee for Quality Assurance (NCQA®), HEDIS is part of a larger system which complements the NCQA accreditation program and establishes accountability in health care. In areas of most concern to your patients, HEDIS helps compare how managed care plans perform.  Magellan Complete Care of Florida closely monitors the HEDIS rates as a way to help us identify opportunities for us to improve the health of our members.  Below is a list of those improvements for 2019 compared to 2018.

  • 4% more members with diagnosis of schizophrenia maintained their treatment with antipsychotic medication
  • 17% more members had an eye retinal exam
  • 6% more members continued their statin medication in order to keep under control cardiovascular conditions
  • 7% more members maintained their asthma treatment with the appropriate medication
  • 6% more members maintained their treatment for depression
  • 3% more members received the appropriate care to control their blood pressure

Visit the AHCA website to learn more about the Performance Measure Data submissions for Medicaid:

https://ahca.myflorida.com/Medicaid/quality_mc/submission.shtml