2020 will allow for consistency for our Medi-Cal line of business as only a few additional required accountability measures have been added from the year prior. For our Medicare line of business, a couple measures will be going away and no notice of additional measures has been given as of the date of this post.
We encourage anyone who has not yet completed EMR data exchange to do so in 2020. A few of our goals based on your EMR’s ability this year will be to redesign work-flows to capture more measurement data and reduce missed opportunities. Part of this strategy involves not only extracting data but pushing alerts to your EMR for HCC and STARS. Details on new provider incentives and special quality care carve-outs will be sent out soon to our contracted providers.
Our goal is to be a strong advocate for our providers. We want to not only deliver gaps in care reports to the providers but also provide them with a variety of tools and resources to be successful. In our efforts to do so, we have developed a HEDIS Toolkit that encompasses all the resources we have available to providers in order to assist them in increasing HEDIS rates.
A few resources we provide our groups include:
- Access to Nivano’s internal data warehouse Atlas, which allows providers to pull real-time gaps in care reports and review their claims and encounters.
- HCC and RAF reports for Medicare providers.
- A HEDIS Coding Cheat Sheet, which lists all codes the biller must utilize in order to collect the data administratively, reducing the amount of administrative disruption from medical record collection during HEDIS season.
- Utilization of Sierra Health Alerts. This communication platform allows providers to interact with patients about their health compliance requirements. Available services include custom automated phone calls, custom automated text messages, bi-directional texting for schedules, and a HIPAA compliant mobile application.
Additional resources include open authorizations, marketing posters for clinic waiting rooms and exam rooms, HEDIS preventive service reminder cards, point of care rewards for the members, and medical record review for missed opportunities.
Quality Management the team here at Nivano Physicians is confident that with the tools and resources we have available to our clinics, and our commitment to work closely with them to provide quality and timely care to our members, we will all be successful in HEDIS 2020!