Performance metrics like HEDIS, Standardized Core Quality Measures (CQMs) and CMS Star Ratings are used to provide consumers with an unbiased view of the quality of different healthcare payers. These standardized measures are essential to dictate how well a payer performed based on certain criteria. It might seem like an arbitrary number or that the HEDIS work you are doing is futile, but it does have an impact on your bottom line. Keep reading to see how HEDIS impacts healthcare payers and what this means for your facility.
What exactly is HEDIS?
You probably already know this one, but here’s a quick recap. HEDIS stands for the Healthcare Effectiveness Data and Information Set. This is a comprehensive set of standardized measures that help consumers determine if the services provided by medical facilities are actually improving healthcare. In other words, it assesses the effectiveness of medical facilities in treating a wide array of conditions.
How does HEDIS impact healthcare payers?
HEDIS might not seem like a big deal, but 90% of health plans in the US use this information to compare healthcare performance between other health plans. Performance is key, which is why you should be using it to assess what areas need to be improved upon across the system. If you are not doing this, you are missing out on an opportunity to present a better image and improve your overall bottom line.
In addition to self-improvement, Medicare plans also use HEDIS measures to record follow up visits to doctors. This is done for people with high-risk conditions that are deemed chronic, after they’ve been admitted to the ED. Medicare plans have specific surveys for HEDIS that needs to be filled out and if you’re not doing it properly, you might get overlooked.
Does your practice need to improve HEDIS scores?
You want to put the best view forward for consumers, but if you are struggling to put together quality HEDIS work your results are going to suffer. HEDIS is important to keep your facility as a viable option. Unfortunately, you don’t always have the time or resources to stay on top of HEDIS tasks. That’s okay because HEDIS Nurses is here to help!
Are you ready to start a partnership with HEDIS Nurses to improve your scores?
At HEDIS Nurses, we know the industry inside and out. We have over 2024 years of experience in the medical record retrieval and management industry and we know the important of HEDIS projects. If you are struggling to keep up with the HEDIS tasks at your facility, contact us today! We have a quality team of nurses with experience in all matters HEDIS. Whether you want help with a few small projects, or would like to outsource all of your HEDIS work, HEDIS Nurses can help! Call us today at (877) 328-2343 to get started. To learn more, visit us on the web at HEDIS Nurses.
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