With
HEDIS 2014 completed, now is the time to start planning for HEDIS 2015. While the
active medical record collection period is short, HEDIS is a year round
activity. There are many opportunities that can be acted on now to make next
results even better for many it’s a matter of data gaps and identifying where
those gaps exist and taking action to close them can drastically improve your
HEDIS and
STARs rates next year.
Reviewing HEDIS 2014
results with claims data throughout the year can give you an insight into where
data gaps with quality of care measures that impact HEDIS and STARs results.
When analyzing this information, you can identify interventions for your health
plans, providers and members. It is important to prioritize interventions by
the impact they can yield.
For health plans, consider what is driving your gaps.
For health plans, consider what is driving your gaps.
- Are gaps resulting from network leakage due to members
visiting providers that are not participating with the plan and aren’t
obligated to provide medical record information? If so, work with your
benefits department to identify ways to message members about in-network
benefits.
- Are there large provider groups that are resistant to
cooperating?
- Do they have EMR? What incentives can you provide to
encourage participation?
Provider
engagement is another key way to improve HEDIS
2015 and Stars results. Providers are challenged with day-to-day operations
of their offices and may not have the resources available to identify members
needing preventative screenings or chronic care management. Targeted reports
providing them with up-to-date patient information can assist them in their
outreach efforts to encourage members to receive timely care. In addition,
identify ways to offer providers options for HEDIS 2015 that can reduce provider intrusion. Do they have EMR
that can be accessed remotely? Do they want to schedule early so they can anticipate
and schedule your HEDIS requests with other plans? Sometimes it’s the little
things that make the provider’s life easier that can help with getting the
responsiveness you need for your HEDIS data collection.
The
health care system is challenging to navigate. By making it easier to
understand, members can become more engaged in managing their health. Depending
on your membership demographics some outreach efforts are more effective than
others. Consider a multi-prong approach such as mailings, voicemail and health
educator outreach to members based on preventative screenings and chronic care
management. Optimize care management programs to remind and follow-up with
members needing services. Sometimes members need a call to action and some
guidance – it’s a win-win.
HPP
Management Group and AccuChecker helping
providers to meet the goals of:
·
HEDIS
·
PQRS
·
Meaningful Use
·
National Quality
Measures
FOR MORE INFORMATION
PLEASE CONTACT:
HPP Management
Group, Corp.
Developers of
the AccuChecker Product Line
Phone: (305)
227-2383
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