At Health Data Vision we realize most Health Plans are at about the halfway point, or hopefully a little beyond, for their 2014 HEDIS® data collection projects.  This is when it gets fun and it is truly the last time to really be able to address problems before it’s too late.  Here are a few things a plan can do to make sure they are on track at the HEDIS® season mid-year point and eliminate surprises in May.

Convenience Sample

Whether you have an experienced review team or long standing relationship with your vendor, it is beneficial to take advantage of the convenience sample.  Even if it is just a couple of charts from each of the measure groups, the convenience sample can help you in ways beyond verifying abstractors understanding of the measure.  It provides a test run for your chart retrieval processes before the actual MRRV. It also ensures that all necessary chart meta data is pulling over correctly and it allows your auditor to provide some feedback that could in fact make the MRRV process less stress inducing.

Data downloads from your vendor

If you haven’t done so yet, you should be getting at least their first data download.  Once a project has been in the field four to six weeks, a sufficient amount of positive hits should be in place for each measure. Then your plan can begin to assess how they are tracking toward goals, and evaluate if they are ahead or behind the pace of prior years.  By week eight, weekly to semi-weekly downloads are advisable.

Reset daily throughput targets and assess staffing level

Slow starts or delays in getting projects to the field can still be overcome, but the time to act is now.  The most important thing to know is what your daily throughput needs to be for all project steps -  from scheduling to chart overread.  If you are going to need to add staff to get the work done, don’t hesitate to escalate that request to your senior management.  Any grouchiness that you will encounter now, for having to tap resources from other parts of the organization for the next three weeks, will be nothing compared to the outrage that is likely to be vented if your plan falls short of goals for preventable reasons.

About The Author

Mike Curran is VP of Quality/HEDIS for Reveleer. He has worked in Managed Care for 25 years and brings extensive management and operations experience to Reveleer, as well as proven ability to build high performing, results-focused teams. Prior to joining Reveleer, he came from United Healthcare where he was the National Director for Clinical Performance Improvement. Mike is a graduate of St. Anselm College where he earned a degree in Politics and Boston University where he earned his Master of Public Health degree.