Prioritizing HEDIS measures to improve performance | Geneia

Prioritizing HEDIS® measures to improve performance

January 09, 2019
Aurel Iuga, MD, MBA, MPH, CMQ, Chief Medical Officer

Geneia's health plan client used analytics to focus on HEDIS measures related to diabetes and prediabetes

In case you missed it, one of Geneia’s health plan clients reported a statistically-significant increase in 16 key HEDIS® measures. Health plan care managers and network providers benefitted from the combination of clinical integration, targeted reminders and efforts by the health plan clinical team – all based on insights from Geneia’s Theon® platform.

Using the Theon® platform to confront the diabetes and prediabetes epidemic

Throughout 2018, we have often written about Lucy.

She’s one of the fortunate prediabetics. Contrary to 90 percent of the 84 million prediabetics, she knows about her condition, thanks to the collaboration and coordination of her health plan, health system and physician made possible with their shared use of the Theon® analytics and insights platform. With help from her care coordinator and nutritionist, Lucy has embarked on the lifestyle changes needed to prevent her from progressing to diabetes.

Lucy is one of the lucky ones. Contrary to 90% of the 84 million prediabetics, she knows about her condition.

Without a doubt, we’re in the midst of an epidemic of diabetes and prediabetes.

Given the epidemic, Lucy’s health plan isn’t the only one focused on identifying and engaging prediabetics and diabetics.

In fact, our health plan client that reported a statistically-significant increase in 16 important HEDIS® measures in the first eight months of 2018 also used the Theon® platform to focus on the HEDIS® measures that can help identify members at risk for diabetes as well as those tied to diabetes management. And the plan’s efforts were successful.

Among the most notable improvements in the health plan’s HEDIS® performance were:

  • Adult BMI Assessment (+17.9%)
  • Comprehensive Diabetes Care – HbA1c Control (<8%) (+12.1%)

Improving HEDIS scores while reducing administrative burden

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