Is Your HEDIS Score Accurate?

Make sure your score is based on good data with help from HEDIS Nurses.

Having a good HEDIS score paves the way for accreditation from the National Committee for Quality Assurance and awards the stars needed to serve Medicare Advantage enrollees. With the population trending older, the last thing health plan providers want is a low HEDIS score that precludes them from serving this group. The situation is even worse when it seems that the HEDIS score does not accurately reflect the reality of care, but instead is compromised by procedural issues with data collection and analysis.

In order to earn HEDIS scores that accurately reflect the quality of care achieved by your company, you absolutely must begin with good data.

As a first step, you must ensure that the staff at the medical clinics and hospitals you partner with is adequately trained in HEDIS measures outlining best practices for care. You can help by providing training resources to keep them updated on the latest updates to HEDIS measures, as a new set of revised measures is released every year.

Next, make sure that the medical staff accurately and completely captures all relevant information about each patient on every visit. Also, ensure that they know how to collate this information and send it to your HEDIS abstractors. Every chart sent to the abstractors should contain all relevant pieces of a medical record, including things like immunization flow sheets or diabetes flow sheets.

Of course, no matter how much data you have it won’t make a difference if you don’t have the right people to interpret it. HEDIS Nurses can pair you with expert nurse abstractors who are highly trained in the latest HEDIS measures and able to perform complete and thorough chart abstractions with a high degree of accuracy. We can even provide nurses with specific areas of expertise that match practice areas like pediatrics for even more informed and accurate abstractions.

Finally, you must have superior software for collecting the finished chart abstractions and transforming this data into finished HEDIS reports. At HEDIS Nurses, we offer our proprietary software, HEDIS Navigator, to all of our clients for this purpose. Using HEDIS Navigator, medical staff can easily and instantly upload scanned charts and documentation to our nurse abstractors and receive the finished output in a format that is compliant with HEDIS reporting requirements.

To learn more about how our services can help improve the accuracy of your HEDIS reporting and your HEDIS score, please contact HEDIS Nurses today.