Improve HEDIS Scores and Star Ratings by Improving Patient Care

The National Committee for Quality Assurance’s (NCQA) HEDIS scores and Centers for Medicare & Medicaid Services (CMS) Star Ratings have become widely used tools to measure and improve healthcare effectiveness. They provide employers and consumers with the objective information they need for reliable comparisons of healthcare quality and outcome measures. Some HEDIS and CMS Star Ratings measures are based on measures across six domains of care including effectiveness of care and utilization. One of the ways to improve your scores is through increased outreach and better follow-up patient care.

 

Unfortunately, many healthcare organizations are currently operating with surprisingly inaccurate or incomplete patient information. Patient data erodes at an estimated rate of 3% per month. It’s in a continual state of flux as individuals change jobs, phones, addresses and even their names (marriages and divorces). The process to keep records current is both cumbersome and a drain on resources. Rather than viewing HEDIS scores and Star Ratings as burdensome, healthcare providers, pharmacies and health plans should see them as opportunities to measure and better coordinate care for improved patient outcomes. These improvements are likely to have a significant advantage in today’s increasingly competitive healthcare market.

How can your healthcare organization improve the HEDIS scores and Star Ratings and impact health outcomes?  With optimized patient data, healthcare organizations can begin the process of contacting patients in the target group to remind them about the importance of preventative screenings. The same approach to patient outreach can be used to encourage patients to obtain immunizations, such as flu and pneumococcal vaccines (another HEDIS measure). The key to success with these approaches to patient care is quality data, which can be achieved using a data hygiene solution.

 

Download our white paper to learn more about how leveraging data hygiene and advanced analytics can positively impact HEDIS Scores and CMS Star Ratings.