Introduction to HEDIS 201 SOUTHERN REGION Measuring quality of care and services provided to our members! Presented By: Rachael French Manager of Quality Improvement Programs
Housekeeping Audio Webinar is recorded We recommend using the telephone dial-in feature instead of your computer microphone See screen for dial-in number, access code, and PIN # Participant microphones have been muted Questions/Comments Please Type Questions into Q&A box. Evaluation at the End of the Presentation 2
Objectives HEDIS Overview HEDIS 201 Performance Key Changes for HEDIS 201 Resources Q&A 3
HEDIS Overview What is HEDIS? Healthcare Effectiveness Data Information Set Administrative vs. Hybrid Measures Why is HEDIS Important? Evaluates clinical quality in a standardized way Identifies opportunities for improvement Measures are used for value based purchasing programs Measures are publicly reported Required by the State
HEDIS 201 Reporting Regions Medi-Cal members Eastern Region (Solano, Yolo and Napa counties) Sonoma County Marin County Mendocino County PartnershipAdvantage Eastern Region (Solano, Yolo and Napa counties)
HEDIS 201 Medical Record Project Chased 17,66 medical records across Eastern (Solano, Yolo, and Napa), Sonoma, Marin, and Mendocino counties 6 provider sites had an onsite visit Retrieved and Reviewed1,600 records in 11 weeks 6
HEDIS 201 Performance Distribution of measures by percentiles Eastern Distribution of Measures by s in Eastern Counties Sonoma Distribution of Measures by s in Sonoma County 100% 90% 80% 70% 60% 6 3 At or above 90th 7th- <90th 100% 90% 80% 70% 60% 7 3 7 At or above 90th 7th- <90th 0% 0% 30% 8 9 9 0th-<7th 2th-<0th 0% 0% 30% 11 7 0th-<7th 2th-<0th 7 20% 10% 0% 1 1 *2012 (N=19) 2013 (N=22) 201 (N= 22) <2th 20% 10% 0% 1 3 3 2 1 *2012 (N=19) 2013 (N=22) 201 (N=22) <2th
HEDIS 201 Performance Distribution of measures by percentiles Marin Mendocino Distribution of Measures by s in Marin County Distribution of Measures by s in Mendocino County 100% 90% 80% 2 2 3 At or above 90th 100% 90% 80% 2 2 3 1 At or above 90th 70% 60% 0% 0% 30% 20% 10% 6 6 6 7th- <90th 0th-<7th 2th-<0th <2th 70% 60% 0% 0% 30% 20% 10% 8 7 6 7th- <90th 0th-<7th 2th-<0th <2th 8 0% 2013 (N=20* ) 201 (N=21*) 1 0% 2013 (N=21*) 201 (N=21*)
HEDIS 201 Regional HEDIS Reporting Reporting Region Counties Included Southeast Napa, Yolo, Solano Southwest Marin, Sonoma, Mendocino, Lake Northeast Modoc, Lassen, Shasta, Siskiyou, Trinity Northwest Humboldt, Del Norte County level reporting 9
HEDIS 201 cont. PHC partnered with a new Medical Record Retrieval Vendor, Enterprise Consulting Solutions (ECS) HEDIS 201 Medical Record Collection Processes & Vendor Introduction Date: Jan 1, 201 & Jan 22, 201 1:00 PM - 2:00 PM PST
Single Contact from ECS Primary Contact from Provider Site
Recap Overview of HEDIS 201 HEDIS Performance Regional Reporting County Level Reporting New Vendor 12
13 Questions
HEDIS 201 Timeline Primary Medical Record Collection and Review 2/1/1 /1/1 Additional data collection to determine county level performance Vendor Schedules medical record collection Medical Record Collection and Review stops /1/1 February March April May June July August PHC provides vendor with list of records to collect Secondary Medical Record Collection Medical Record Review Validation Audit /19/1-/29/1 HEDIS Results locked in 6/16/201 HEDIS 201 performance shared with Provider Network
Medical Record Collection & Vendor Introduction (Content is the same on both dates) Recommended Audience: Quality leadership, Management, and Office Medical Record Staff Date: Jan 1, 201 & Jan 22, 201 1:00 PM - 2:00 PM PST HEDIS 201 Refresher (Content is the same on both dates) Recommended Audience: Quality leadership, Management, and Office Medical Record Staff 1 Date: Feb 11, 201 & Feb 17, 201 1:00 PM - 2:00 PM PST
Resources HEDIS Website: http://www.partnershiphp.org/provider/mc_hedis.htm NCQA website for more details on HEDIS: http://www.ncqa.org/hedisqualitymeasurement.aspx Contact us! Email: HEDISMRA@partnershiphp.org Phone: (707) 863-282 16
17 Questions