How Health Plans Impact Revenue Performance and Improve Quality Outcomes

By Claire Thayer, March 2, 2017

The Healthcare Effectiveness Data and Information Set (HEDIS) measures developed by the National Committee for Quality Assurance (NCQA) are now used by over 90% of health plans to measure quality performance.  HEDIS consists of 81 measures across 5 domains of care and address a broad range of important health issues, including:     

• Asthma Medication Use
• Persistence of Beta-Blocker Treatment after a Heart Attack
• Controlling High Blood Pressure
• Comprehensive Diabetes Care
• Breast Cancer Screening
• Antidepressant Medication Management
• Childhood and Adolescent Immunization Status
• Childhood and Adult Weight/BMI Assessment

Many health plans report HEDIS data to employers or use their results to make improvements in their quality of care and service.  Each year, NCQA publishes The State of Health Care Quality Report to raise awareness on key quality issues and drive improvement in the delivery of evidence-based medicine. This report documents performance trends over time, tracks variation in care and recommends quality improvements.  Additionally, HEDIS data is also incorporated into many health plan ‘report cards’ and increasingly used by consumers and purchasers to track and compare health plan performance.

This week, a special edition of the MCOL Infographic, co-sponsored by DST Health Solutions, focused on strategic trends and key elements of performance improvement for health plans: 

 

MCOL’s weekly infoGraphoid is a benefit for MCOL Basic members and released each Wednesday as part of the MCOL Daily Factoid e-newsletter distribution service – find out more here.