How HEDIS Reporting Helps Consumers

Results of HEDIS reporting help consumers navigate a changing health care environment

HEDIS NursesOne result of all the changes occurring in health care due to the implementation of the Affordable Care Act is that many Americans have been dropped by their health plan providers. Some of these individuals may decide to choose a different plan with the same provider, while others may opt to choose a different provider entirely. For anyone needing to select a new health plan, or for anyone simply wishing to learn more about the performance of their current plan, HEDIS reporting data is invaluable. Here’s why.

HEDIS Reporting Data is Used for Accreditation

First of all, HEDIS reporting data is used by the National Committee for Quality Assurance (NCQA) to award accreditation to various health plan offerings. NCQA accreditation signals to the consumer that the health plan in question has passed a rigorous performance review and scored well in prevention, treatment, chronic condition management, access to care, and physician quality. Nearly 85 percent of the health plans currently offered in the health care exchange marketplaces set up as a result of the Affordable Care Act have NCQA accreditation, so people looking for health plans should have a wide range of good choices.

HEDIS Reporting Data Allows for Easy Comparison of Plan Performance

Another way HEDIS reporting activities help the consumer is by allowing for different health plans and providers to be more easily compared to one another. NCQA even offers a special tool for this purpose, called Quality Compass, which allows consumers to search for plans and providers and compare their performance on specific HEDIS measures and care benchmarks. Consumers can also access Health Plan Report Cards through NCQA, which provide a snapshot of a health plan’s performance across important HEDIS measures.

HEDIS Reporting Allows Plan Providers to Offer Better Care

Finally, HEDIS reporting activities help consumers by allowing health plans to evaluate their own performance against goals set by NCQA as well as against their own in-house goals. The ability to accurately and objectively measure performance is very helpful because it continually pushes plans and providers to improve their offerings, which in turn results in better care for patients.

What’s Your HEDIS Reporting Based On?

With so much depending on the results of HEDIS reporting, it’s no surprise that health plan providers want to make sure their results are as accurate as possible. Trying to complete a reporting project with overworked or undertrained staff can be disastrous. Fortunately, health plan providers can turn to HEDIS Nurses for help. We can provide the trained staff you need to extract patient data from medical charts quickly and accurately, as well as the software needed to collect, compile, and transmit this data securely and efficiently. With our nurse abstractors and technology providing the groundwork for your reporting project, you’re sure to arrive at results that accurately and fairly reflect the reality of your plan performance.