HEDIS Quality Measures

HEDIS quality measures

NCQA decided to establish the Healthcare Effectiveness Data and information set (HEDIS) as quality performance measure that was designed to give information that is relevant for the comparison of the health performance. The measures are important for the public health issues such as heart disease, asthma, cancer, and diabetes. HEDIS includes 81 measures that have cut across eight domains of care (Kern et al., 2016). Due to many plans using HEDIS, it means that the HEDIS measures can be used to make comparisons among the plans covering a broad range of health issues that are relevant to the consumers in dimensions of service and care.

HEDIS measure

In the United Kingdom, between 11%-28% of the patients that have had fragility fractures have received treatment through osteoporosis treatment. The UK department of health has endorsed fracture liaison services that have reported treatment rates to have improved approximately 88-96%. This, however, has not been fully adopted hence showing some positive impact. Markov modeling has revealed a cost-effectiveness analysis of the West Glasgow Fracture liaison services (FLS) that has been collected and analyzed for eight years. It is therefore evident that there would be 18 fractures that may be avoided and three life years that would be saved per 1000 patients that would be assessed with cost savings that were substantial.

This HEDIS measure has been used to look into the effectiveness of care that has been related to various categories such as screening and prevention, behavioral health and medication management. The measure has also focused on the availability of care and the various outpatient and inpatient services. This has also improved the resource utilization, enhanced care coordination and improved quality of clinical outcomes through quality preventive services and care (Casalino et al., 2016). This has improved the operational performance through the availability of care.

HEDIS measures cite some advantages because they undergo a rigorous selection process (Chassin et al., 2010). The process has steps that include include measures’ assessment, field testing, a trial period, public comment and the evaluation of the publicly reported measures with statistical analysis, user comments and audit results. HEDIS has also released useful data that has been used for evaluation of current performance and also enable setting of goals. It has also enabled cost-effective practices that have enabled health outcomes. The health measures have reflected the care that patients have received for quality improvement activities.

Quality performance

As a consumer of this type of healthcare services, it is considered important to seek the health plans and measures to provide the best quality, best value and best communication practices that have considered all the factors effectively (Kern et al., 2014).  HEDIS has ensured quality metrics that have revealed scorecard that has shown a good health performance and has influenced an individual to make best selections which have directly impacted organization’s bottom line regarding consumers. HEDIS measures have played a critical role in the health industry through closing gaps in healthcare and preventive measures that are cost-effective. It has put the focus on quality improvement and more value-based care across the healthcare organizations.

Conclusion

This has made HEDIS a greater subject to providers as they try to achieve their goals. This has boosted adoption of new technologies and HEDIS quality scores through the implementation of preventives and screening rates among the networks of the providers. The payers will, therefore, require strong clinical documentation, health management and engage with providers to raise HEDIS quality score to facilitate quality of care.

 

References

Chassin, M. R., Loeb, J. M., Schmaltz, S. P., & Wachter, R. M. (2010). Accountability measures—using measurement to promote quality improvement.

Casalino, L. P., Gans, D., Weber, R., Cea, M., Tuchovsky, A., Bishop, T. F., … & Evenson, T. B. (2016). US physician practices spend more than $15.4 billion annually to report quality measures. Health Affairs, 35(3), 401-406.

Kern, L. M., Edwards, A., & Kaushal, R. (2014). The patient-centered medical home, electronic health records, and quality of care patient-centered medical home and quality of care. Annals of internal medicine, 160(11), 741-749.

 

Complete Answer:

Get Instant Help in Homework Asap
Get Instant Help in Homework Asap
Calculate your paper price
Pages (550 words)
Approximate price: -
Open chat
1
Hello 👋
Thank you for choosing our assignment help service!
How can I help you?