Performance levels are fast becoming the new currency in healthcare. After all, quality scores are the primary way that plans are rated for quality care delivery and billions of dollars in reimbursements hinge on quality ratings.
As the most widely leveraged performance measure set, HEDIS tracks important dimensions of quality care and service. Under the shift to delivering quality and better outcomes, measuring value is a critical component of care. However, care gaps emerge in challenging populations such as Medicare and Medicaid and in Commercial populations as well. Closing gaps requires comprehensive planning and approaches.
With seven new HEDIS measures for 2018, it is an ideal time to assess your preparedness. In addition to the new measures, there are changes to four existing measures and two cross-cutting topics that address issues across multiple measures. At a minimum, your chosen quality improvement solution should help you:
- Meet year-round quality rating goals
- Identify and segment at-risk members for intervention or prevention
- Use the best communication mix to engage members
- Remove complex compliance barriers
- Refer physicians and schedule appointments
- Provide clinical support immediately
As more health plans implement quality improvement programs, minimizing burdens and closing care gaps is the goal with better tools and solutions for streamlining reporting.
Citra closes more gaps in care – call us to learn more.
