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Health Plans

Early bird gets the worm: Health plan quality measure reporting

March 30, 2017
Early Bird Gets the Worm: Health Plan Quality Measure Reporting
President and CEO

As a morning person, I am a strong believer in the idea that ‘the early bird gets the worm.’ That’s why I get up before sunrise most days to organize my day, exercise and write. I often get more accomplished before 9:00 am than I do during the rest of the day.

Undoubtedly, the ‘early bird’ health plans tend to perform better on quality measure reporting including HEDIS® measures and Medicare Star ratings. If you’re a health plan employee working in this area, you likely are well-aware there are only 276 days until the 2017 reporting period ends for most HEDIS® measures (some are time-limited and end even sooner, e.g. health plans have only six months to assess the women ages 65-85 with a fracture for osteoporosis management) and Medicare Star ratings.

Knowing how important an early start is to HEDIS® and Medicare Star rating success, we’ve spent the past few months creating free resources for health plans, including:

At the heart of our work in helping health plans improve their HEDIS® and Medicare Star results is Geneia’s advanced analytics platform. The Theon® solution collects and integrates timely information from more than 25 sources, including:

  • Member data
  • Demographic
  • Claims
  • Costs
  • Laboratory
  • Pharmacy
  • Durable medical equipment
  • Procedures
  • Care provider data
  • Hospital discharge data
  • National Committee for Quality Assurance HEDIS® measures, and more.

Theon 3 QuestionsThrough analytics and easy-to-use dashboards and scorecards, the Theon® platform simplifies the process of identifying and closing care gaps – many automatically. Just as importantly, our analytics solution supports the comprehensive communication and collaboration needed between health plan staff, participating providers and their staff.

We are able to implement the Theon® platform in as few as 12 weeks, meaning there’s still time to deploy it to improve your health plan’s HEDIS® and Star Ratings performance in 2017.  In our experience, using an advanced analytics solution to create cost-efficient repeatable processes that satisfy the health plan and network providers surely beats expensive, labor-intensive, one-off tactics such as mobile mammograms and bone density scans, community health fairs, and ‘chart chasing.’ The early bird truly does get the worm.