Just because the HEDIS® reporting season has ended, doesn’t mean that there is not still valuable chart review to be done. Those charts that hold value for HEDIS® scores and Stars rating could be coming into your organization right now.
Risk Adjustment chart collection occurs virtually year-round and there is a very good chance that your plan is acquiring charts right now for that purpose. Although there are clearly limits to how you can use partial year chart data for HEDIS® reporting, mining these charts in the HEDIS® off-season can yield potential outreach opportunities and possible valid exclusions for low denominator, administrative-only HEDIS® measures.
HDVI’s STARs Improvement initiatives help plans leverage existing chart information from risk activities as well as gather additional charts as needed to impact several hybrid and administrative measures, including:
- Controlling High Blood Pressure
- Comprehensive Diabetes Care – BP
- Comprehensive Diabetes Care - Eye Exam
- Osteoporosis Management in Women who had a Fracture (OMW)
- Drug Therapy for Rheumatoid Arthritis (ART)
Although you cannot use the blood pressure values found in the chart to satisfy the actual reporting for HEDIS® 2016, review of these charts can help identify non-compliance mid-year and potentially focus outreach. In the cases of measures like OMW and ART, these generally have low denominators and fairly wide exclusion criteria. Locating only a few valid exclusions, that your auditor approves, can help a plan move the needle on these administrative-only measures.
