How can I increase my HEDIS score?

How can I increase my HEDIS score?

Ways to Improve HEDIS Reporting Efficiency

1. Effectiveness of care.
2. Access/availability of care.
3. Experience of care.
4. Utilization and relative resource use.
5. Health plan descriptive information.
6. Measures collected using electronic clinical data systems.

What are the most important HEDIS measures?

HEDIS® includes more than 90 measures across 6 domains of care:

• Effectiveness of Care.
• Access/Availability of Care.
• Experience of Care.
• Utilization and Risk Adjusted Utilization.
• Health Plan Descriptive Information.
• Measures Reported Using Electronic Clinical Data Systems.

What is HEDIS risk adjustment?

Many HEDIS measures are closely aligned with the focus of risk adjustment programs that strive to accurately assess the health status of individual members. As risk profiles become more accurate, risk adjustment becomes more effective so health plans are appropriately compensated for the risk of their enrollees.

What are the 5 domains of care for HEDIS?

HEDIS measures clinical quality and customer service, requiring standardized reporting under 5 domains of care:

• Effectiveness of Care.
• Access/Availability of Care.
• Experience of Care.
• Utilization and Risk Adjusted Utilization.
• Health Plan Descriptive Information.
• Measures collected using Electronic clinical data Systems.

How do you close HEDIS gaps?

Tactics for HEDIS best practices

1. Amplify every connection. To improve quality measure performance, every patient or plan member connection must address more than one objective.
2. Teach at every touchpoint.
3. Coordinate care as needed.

Why do health plans care about HEDIS measures?

Health plans use HEDIS to see where they are performing well, and where they need to improve. Employers and consumers can also let you use HEDIS measures when deciding what health plan to choose. Plans that meet a certain HEDIS score may become “accredited.”

How often are HEDIS measures revised?

Measures are revised every year to include newer and even more effective Best Practice Guidelines. According to a 2005 study, HEDIS-Medicaid 3.0 measures covered only 22% of the services recommended by the second U.S. Preventive Services Task Force (USPSTF).

What is hedis 2020?

Description: The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool used by more than 90 %of America’s health plans to measure performance on important dimensions of care and service. HEDIS consists of 71 measures across 8 domains of care. HEDIS is used by more than 90% of America’s health plans.

Are all quality measures risk adjusted?

Social risk adjustment is not appropriate for all quality measures. Measure developers should examine each quality measure individually to determine whether social risk adjustment is appropriate, taking a quality measure’s empirical relationship with individual social risk factors into consideration.

How often are HEDIS measures updated?

To ensure that HEDIS stays current, the National Committee for Quality Assurance (NCQA) has established a process to evolve the measurement set each year through its Committee on Performance Measurement.

What do you really know about HEDIS?

What Is HEDIS? HEDIS is a rating system that uses many different specific measures or standards to compare the performance and care of most health plans in the United States. The ratings are performed each year and cover an extremely broad range of issues affecting health plans.

What are the HEDIS quality measures?

The Healthcare Effectiveness Data and Information Set (HEDIS) is a widely used group of measures that quantify quality performance among healthcare payers and providers in any given year. Some common HEDIS quality measures involve childhood immunization status, cancer screenings, asthma medication management,…

What are HEDIS star measures?

The Star measures are made up of performance measures from HEDIS, CAHPS , HOS (measures comparison of members health plan assessment over 2 years), Prescription Drug Program and CMS administrative data. HEDIS consists of standardized performance measures.

What are HEDIS care gaps?

HEDIS Helps Payers Close Gaps in Care. The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool used for health care performance measurement. Called the “Gold Standard” by the NCQA , HEDIS is used by 90% of Health Plans in the country. HEDIS is important because it standardizes how plans collect, audit and report critical clinical data.