Companies like General Medicine, P.C. can tout their success based on HEDIS ratings
HEDIS reporting performs a very important role in our health care system, namely that of enabling consumers to compare and evaluate different health plans and providers. HEDIS reporting also allows for accountability and oversight, as health plans and providers can’t hide poor results from the public if they wish to continue to hold a certification from the National Committee for Quality Assurance (NCQA), the entity that administers and updates HEDIS standards.
HEDIS standards encompass eight different domains of care, using a total of 75 different measures to assess performance. Health plan providers that perform well on various measures often use this fact as a promotional tool to help advise the public of their achievements. Here is one example of a company that was proud to incorporate their HEDIS performance ratings into their marketing plan.
General Medicine is a medical practice that provides specialized services related to geriatrics, physical medicine, rehabilitation and care for post-acute hospital patients and long-term care residents. The company currently provides services to over 300 managed care plans, including Medicare and Medicaid, at over 1,000 facilities across the country. Earlier this month, General Medicine was proud to announce that that their care and service performance ranked in the top 10 percent of all plans in the country for 2013.
Some of the specific achievements made by General Medicine included:
- Reducing hospital readmissions by 52 percent compared to the national average
- Reducing the average length of hospital stay by 1.25 days
- Reducing unnecessary ER visits by 33 percent
- Reducing overall healthcare spending
- Improving the transition process for patients moving between inpatient hospitals, post-acute facilities, and home settings
All of these achievements are related to the broad goals and metrics set by the NQCA through their HEDIS measures. Without the HEDIS reporting process, General Medicine would not have had a way to evaluate their own performance objectively and in a manner that is easy to compare with other providers across the country.
Of course, in order for the results of HEDIS reporting to be useful for marketing purposes, they must be accurate. In order to be accurate, they must be based on high-quality data. That’s where the services of a company like HEDIS Nurses comes into play. HEDIS Nurses can provide health plan providers with the expert chart abstraction staff they need to effectively and accurately gather the data that will form the basis for useful performance evaluations. If you are interested in the difference a dedicated professional chart abstraction service could make in the quality of your HEDIS reporting, please contact HEDIS Nurses today.
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