Quality, HEDIS and STARS – Nivano Physicians | Comprehensive Healthcare Services in Northern California

Quality, HEDIS, and STARS

Quality care and preventive healthcare services improve patient outcomes.

Nivano Physicians has Medi-Cal and Medicare contracts. We provide excellent health care quality.

Both programs measure an IPA and provider’s performance on quality of care indicators.

Medi-Cal uses HEDIS (Healthcare Effectiveness Data and Information Set). Medicare uses Star rating systems.

These tools measure children’s annual well visits, women’s health screenings, chronic disease management, and care transitions.

Our program meets CMS requirements and supports providers in giving the best patient care.

Our Mission: Supporting Provider Success Through Quality Measurement

Our mission is to help healthcare providers with the current and complete reporting tools you need to close care gaps and improve health care quality.

We provide many resources, technical specifications, and audit support. You have what you need to do well in HEDIS and STARS performance metrics.

Our Quality team works with providers to improve preventive healthcare delivery and follow NCQA standards.

For help with quality measures, connect with our support specialists.

Why Choose Us?

Experience the Nivano Difference in Healthcare

At Nivano Physicians, we work closely with providers to support high standards in patient care through HEDIS and Medicare STARS performance.

We give you tools, reporting, and regulatory expertise to help you deliver preventive care, manage chronic conditions, and close care gaps for Medi-Cal and Medicare patients.

Our Quality team gives you personal support and easy-to-use reporting tools that follow NCQA and CMS standards.

We help you prepare for audits and meet quality benchmarks. Quality care means better outcomes for every patient.

Highly-Qualified Professionals

Board-certified physicians committed to exceptional patient care.

Top-of-the-line Equipment

Advanced medical technology for accurate diagnosis and treatment.

Fast and affordable services

Efficient scheduling with competitive pricing and quality care.

Satisfaction Guaranteed

High patient satisfaction through personalized, responsive service.

Understanding What Quality Measures Assess

HEDIS and STARS quality measurement systems let us review how providers perform and make sure members get excellent care. These evidence-based tools look at three main areas that improve health outcomes.

The first area focuses on preventive healthcare services and care plans to stop health from getting worse in patients with chronic conditions.

The second area makes sure members who need important medical services can get them quickly. Healthcare providers work together in care delivery.

The third area makes sure anyone who needs medical appointments can get them within clinically appropriate time. This ensures quick access to care.

2020 HEDIS Measures and Technical Specifications

Access detailed information about each focus measure through our comprehensive resource library designed to support your HEDIS compliance efforts.

Our technical specifications provide healthcare providers with precise guidelines for meeting quality measures and improving patient outcomes.

Download the 2020 HEDIS Specifications for complete measurement criteria and implementation guidance. The 2020 HEDIS Coding Cheat Sheet offers quick reference tools for accurate documentation and reporting.

Don't Miss Your Medicare Enrollment Deadline!

Explore Medicare Advantage plans that include Nivano Physicians—an Independent Physician Association with 400+ primary care physicians, 1,200+ specialists, and 89 urgent care centers across Northern California.

Annual Enrollment Period ends Dec. 7th.

Or Call (916) 407-2000 ext. 2512

Comprehensive HEDIS Toolkit and Resources

Our extensive 2020 HEDIS Toolkit provides healthcare providers with essential resources for successful quality measurement implementation.

This comprehensive collection includes audit preparation materials, compliance guidelines, and preventive healthcare protocols aligned with NCQA standards.

The toolkit supports accountable care organizations in achieving excellence across all healthcare effectiveness data and information set measures while maintaining focus on patient-centered care delivery.

How Can We Help

Supporting Your Quality Measures Success

Our quality measures toolkit gives information about the tools and services we provide. This includes reporting systems, provider incentives, and member transportation help.

These resources help healthcare providers achieve the best HEDIS and STARS performance while improving overall health care quality for our community.

Connect with our Quality team for help with quality measurement implementation, audit preparation, and compliance support.

Excellence in Healthcare Quality Measurement

Nivano Physicians works to improve health care quality. We offer quality measures programs and provider support services. We work with Medicare and Medicaid programs to provide healthcare services to many patients.

We help healthcare providers with HEDIS compliance, STARS performance optimization, and preventive healthcare delivery.

Our Quality team provides technical specifications guidance, audit support, and performance reporting to help providers give better patient care and improve quality outcomes.

For help with quality measures, contact our team for assistance.

Partner with California’s Premier Healthcare Administration Team

Experience the Nivano Physicians difference — where healthcare administration meets genuine patient advocacy, and your well-being always comes first.

Take the first step toward better health today with your FREE Annual Wellness Physical — no copay, no cost, just proactive care built around you.

Quality Measurement Tools for Provider Success

Our quality measurement tools help healthcare providers give excellent preventive healthcare services. They also help meet healthcare effectiveness data requirements.

These systems give real-time performance data and care gap identification. They provide helpful information for improving quality of care delivery.

Our reporting tools connect with electronic health record systems. This helps track HEDIS measures and STARS performance indicators. It also supports evidence-based clinical decision making.

Medicare and Medicaid Quality Standards Compliance

Nivano Physicians meets CMS quality standards for Medicare and Medicaid programs. We use quality checks to stay on track.

Our system includes NCQA guidelines, technical specifications, and audit requirements. These help providers meet all rules.

We provide education about quality measures updates, performance benchmarks, and best practices in accountable care organizations and value-based care delivery models.

Nivano Physicians Patient Testimonials

At Nivano Physicians, quality care isn’t just measured in data—it’s reflected in the lives we help improve. Here’s what some of our patients have to say about their experiences:

They Took the Time to Listen

“I was overwhelmed trying to manage my diabetes and get the preventive screenings I needed. My doctor through Nivano made everything so much easier. They took the time to listen, helped me schedule appointments, and made sure I got follow-up care. I finally feel in control of my health.”

Alfred G.

A Team That Really Cares

“I’ve been through several Medicare plans and providers, but none have supported me like Nivano. From helping with appointments to checking on my medications, it’s clear they really care. I’ve never had this level of attention and coordination before.”

Diana M.

I Got the Preventive Care I Was Missing

“I wasn’t aware how many preventive services I qualified for. Thanks to Nivano’s outreach and support, I’ve had my annual checkup, mammogram, and screenings—all in the past year. It feels good to know my health is being taken seriously.”

Brenda K.

Say Hello

Advancing Community Health Through Quality Measures

Our quality measures program helps improve community health. It supports preventive healthcare and chronic disease management across our provider network.

We use quality measurement and performance improvement to help healthcare providers address social determinants of health, reduce health inequities, and improve patient outcomes.

Working together, we make sure quality of care improvements help entire communities while supporting provider success in value-based care arrangements.

GOT QUESTIONS?

Check Out Our FAQs

What are HEDIS measures and why are they important for healthcare providers?

HEDIS (Healthcare Effectiveness Data and Information Set) measures are standard ways to check health care quality and provider performance. NCQA created these measures. They check preventive healthcare services, chronic disease management, and patient outcomes. For healthcare providers, HEDIS measures are important for showing quality of care, meeting regulations, and joining value-based care. Good HEDIS performance helps provider reputation, improves patient outcomes, and helps overall community health. Contact our Quality team for help with HEDIS.

How do Medicare STARS ratings differ from HEDIS measures?

Medicare STARS ratings are for Medicare Advantage plans. They use a 5-star rating system to check plan performance in areas like health outcomes, member experience, and administrative efficiency. HEDIS measures focus on clinical quality indicators and preventive healthcare services. STARS ratings cover more areas of plan performance like customer service, care coordination, and member satisfaction. Both systems use healthcare effectiveness data to improve quality. But STARS ratings affect Medicare reimbursement and plan marketing. Our team gives complete support for both systems.

What resources does Nivano Physicians provide to help with quality measures compliance?

Nivano Physicians offers many resources. These include technical specifications, coding cheat sheets, performance reporting tools, and audit preparation materials. Our quality measures toolkit gives step-by-step help for HEDIS and STARS compliance. Our Quality team offers one-on-one help and continuing support. We also provide educational materials about preventive healthcare protocols, care gap identification tools, and ways to improve performance. Access our complete resource library or contact our Quality specialists for personal support with your quality measurement needs.

How can providers access performance reporting and identify care gaps?

Our reporting systems give real-time access to quality measures performance data. This helps providers track HEDIS and STARS metrics. These tools identify care gaps, show ways to improve, and give useful information for improving patient outcomes. Providers can access performance dashboards, get automated alerts for care opportunities, and download reports for improvements. Our Quality team gives training on how to use these tools and get the most from them. For reporting access and training, contact us for assistance.

What support is available for quality measures audit preparation?

Nivano Physicians provides audit preparation support. This includes documentation review, compliance verification, and technical specifications guidance. Our Quality team does pre-audit checks, finds areas of concern, and gives help to fix problems so you pass audits. We offer training on audit requirements, documentation standards, and quality assurance processes to help providers stay in compliance. Our audit support services include both HEDIS and STARS preparation, making sure you are ready for all quality measurement evaluations. Contact us to schedule audit preparation help.