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South Carolina Medicaid: Measuring our performance

Learn how we measure our performance and make sure you get the care and services you need to manage your health.

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Making sure you have the care you need

To help us track our progress, we use a tool called HEDIS® (Healthcare Effectiveness Data and Information Set) to measure the performance of many important health issues. More than 90 percent of health plans in America use this tool. Having this large amount of data makes comparing plans easier. Officials check this data using a process created by the National Committee for Quality Assurance (NCQA).

What is measured

HEDIS helps us measure the performance of many health issues, including:

  • Antidepressant medication management
  • Asthma medication use
  • Breast cancer screening
  • Childhood and adolescent immunization status
  • Childhood and adult weight/body mass index assessment
  • Comprehensive diabetes care
  • Continuing use of beta-blocker treatment after a heart attack
  • High blood pressure control

Helping us improve

These measurements:

  • Help us see that Humana Healthy Horizons® in South Carolina meets our members’ needs
  • Show us any areas that need improvement and how we can better serve our members

Check our scores

We want you to feel confident that you made the right choice in your plan. View the HEDIS State of Health Care Quality Report:

View the State of Health Care Quality Report

Learn more

If you’re interested in knowing more about the measures, you can:

Quality Improvement (QI) program

To help us provide you with quality care, we developed a program to make sure we are always improving. To receive a copy of the Quality Improvement Program Description Overview, please contact Member Services at 866-432-0001 (TTY: 711), Monday – Friday, 8 a.m. – 8 p.m., Eastern time.

Looking for help?

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If you have questions, find the number you need to get help and support.

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Documents & forms

Find the documents & forms you need, including your Member Handbook.