Like it or not, we live in a world where independent reviews and rankings mean everything. Consider your purchasing behavior. Whether buying gadgets or traveling the world, chances are you read independent reviews and reports that inform your decisions. This is not new behavior – Consumer Reports magazine, for example, has been in publication since 1936. What is new is the unprecedented access to rankings and reviews. Online ranking is a game changer.
The gold standard for health plan ranking is the National Committee for Quality Assurance (NCQA) Health Plan Report Card. The report card aligns with CMS star ratings for Medicare Advantage plans and is the basis for the annual Consumer Reports Health Plan Rankings report. Consumers, employers and health plans themselves rely on NCQA scores and accreditations to accurately evaluate and compare the quality of care and service delivered.
HEDIS® (Healthcare Effectiveness Data and Information Set) measures are the foundation for these comparative reports. Understanding and improving HEDIS reporting is critical to improving both.
The path is easy to understand, but the execution is complicated and meaningful improvement difficult to achieve. In the past, health plans carried reams of paper reports to physicians – reports which all too often wasted time due to inaccurate, incomplete and out-of-date information. Today, an end-of-year scramble seems to be the most widely adopted approach. There’s a better way.
Technology is available to provide continuous, accurate and current information, complete with transparent access down to the raw data.
This enables health plans to:
- Ease reporting burden for everyone by reporting throughout the year
- Evaluate provider effectiveness (against national, regional and network benchmarks)
- Target high-value measures that improve Medicare star ratings
- Motivate provider compliance
- Monitor and improve ongoing performance
To learn more about improving your NCQA ranking and accreditation scores through a strategic approach to improving HEDIS® reporting, download our free white paper.