Quality, HEDIS & STARS

Quality care and preventative services are key to contributing to a healthy community. Nivano Physicians holds both Medi-Cal and Medicare contracts. Both lines of business have their own tools to measure an IPA and a provider’s performance on specific preventive measures. Medi-Cal uses HEDIS (Healthcare Effectiveness Data and Information Set) and Medicare uses Star rating. These measurement tools include measures ranging from children annual well visits, women’s health and disease management.

Our Mission

Our mission and commitment to you is to provide the most up to date reporting in order for you to be successful at addressing any care gaps. We also want to provide you with as many tools and resources as possible to ensure quality and timely access to care for our members

What is Being Measured?

HEDIS and Stars allow us to review provider performance and make sure they are offering quality care to our members by condensing all of the measures into three key areas:

  1. Providing preventative health and following a care plan to keep those who are sick from getting worse.

  2. Making sure those who need critical services are able to receive them and anyone who can help is involved in member care if necessary.

  3. Ensures that everyone who needs an appointment can get one within a reasonable timeframe.

2020 HEDIS measures

Click on the below resources to get more detailed information about each focus measure of 2020.

How We Help

Our toolkit provides detailed information about the many tools we offer from reporting, EMR integration to member outreach, incentives and transportation. Connect with our Quality team by calling us 916-407-2000 or email HEDIS@nivanophysicians.com for more information.

Physician Incentives

We offer incentives to both members and doctors for addressing quality care. Some measures like Prenatal and Post Partum Care have direct incentives tied to them while other measures are part of a pay for performance incentive. Click Here for more information.

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