Are you trying to stay up to date with your HEDIS measures and tasks? The good news is that HEDIS Nurses can help!
What is HEDIS?
HEDIS stands for the Healthcare Effectiveness Data and Information Set. This is a set of managed care measures that is released every year by the National Committee for Quality Assurance. Essentially, HEDIS is a measurement tool that is utilized by health plans to gauge performance in regards to the quality of care and customer service. It is also used by the Centers for Medicare and Medicaid to monitor the performance of managed care organizations.
What does a HEDIS calendar look like?
Every year, the NCQA sets a deadline in May for health plans to complete their HEDIS data collection and report their findings. A typical HEDIS calendar follows the following timeline:
- January to May: The Clinical Quality staff initiates the medical record requests from appropriate providers.
- June: The results are reported to the NCQA.
- July: The NCQA releases the Quality Compass commercial edition.
- August: The projected health plan ratings for Medicare, Medicaid, and commercial plans are released.
- September and October: The NCQA released the Quality Compass Medicare and Medicaid editions. In addition, the final health plan ratings are posted online.
How is HEDIS data collected?
HEDIS data is actually collected in four different ways. Administrative data collection is data that is collected from claims, encounter, provider, and eligibility data. Hybrid data is information that is gathered from claims and reviews of medical records. Survey data is, as the name suggests, data that is gathered from member and provider surveys. Last, but certainly not least, Electronic Clinical Data is data that is gathered from EHRs, clinical registries, administrative claims processing, and case management. Overall, these four data collection measures help health plans gather data that is then analyzed and reported to the NCQA.
Contact HEDIS Nurses today for help with your HEDIS tasks and projects!
Do you need help with your HEDIS projects? As you can see above, the HEDIS calendar is pretty strict and failure to meet specific deadlines can negatively impact the quality scores that a health plan receives. If you are a health plan looking to boost your HEDIS quality measure scores, you should contact HEDIS Nurses today. For over 2020 years, we’ve been providing health plans assistance with their HEDIS tasks, including chart abstractions. Give us a call today at (877) 328-2343 to learn how we can help you.
To learn more about the reliable HEDIS management services that we offer, visit us on the web at HEDIS Nurses.