HEDIS 2013: Your Cooperation is Needed and Appreciated
Posted on January 4, 2013
For six consecutive years, the National Committee for Quality Assurance (NCQA) has ranked HNE in the top 15 health plans nationwide. We look forward to maintaining this position with the help of the clinicians.
The NCQA’s standardized measurement criteria—known as the Healthcare Effectiveness Data and Information Set (HEDIS)—includes clinical components, which are measured using data from claims and medical record reviews. In 2013, HNE will be reviewing medical records for the following HEDIS measures:
- Adolescent immunization status (including Human Papillomavirus Vaccine (HPV) for female adolescents)
- Adult Body Mass Index (BMI) assessment
- Childhood immunization status
- Cholesterol management for patients with cardiovascular conditions
- Colorectal cancer screening
- Comprehensive diabetes care
- Control of high blood pressure
- Immunizations for adolescents
- Prenatal and postpartum care
- Weight assessment and counseling on nutrition and physical activity for children and adolescents
In the next few weeks, you may receive a letter requesting copies of medical records. We appreciate your assistance in providing the medical information as requested. All information is needed by March 15, 2013 in order to meet regulatory requirements.
Your prompt response will ensure that HNE’s HEDIS measures accurately represent the high quality of care that you provide to our members. If you have questions about the HEDIS 2013 requirements or our medical record review process, please contact Pat Scheer, Director of Quality Operations at 413-233-3435.
