HEDIS® Medical Record Review
Most HEDIS® Medical Record Review (MRR) projects are dreaded and often ill-executed initiatives. In the past, this part of HEDIS® was often handled in a ‘let’s just get it over with’ type attitude. Results varied, consequences often were not severe.
That is changing. Driven by fundamental shifts in the provider landscape (ACOs, medical homes, EMRs) to state and federal government programs (STAR Ratings, ICD10, HIEs), HEDIS® MRR is quickly rising in strategic importance.
HDVI is categorically positioning its services as a best-of-breed partner for health plans and HEDIS®-certified software vendors. We see HDVI’s job as proactively and efficiently working with providers to retrieve every relevant medical record possible, abstracting them correctly and delivering the results reliably back to the health plan or vendor to maximize HEDIS® rates for hybrid measures. This approach allows the health plan to strategically plan, oversee progress and resolve any provider or data issues that may impact results. HDVI provides the process, the technology and, in many cases, some or all of the project team.
HDVI’s best practices have us start working with clients well ahead of the HEDIS® season. Planning, benchmark setting, data strategy, integration work, project logistics, configuration and setup are done well ahead of loading data, which results in more accurate data collection and analysis. Aggressive timelines, weekly guaranteed benchmarks and guaranteed project completion weeks ahead of the submission deadline leaves room for analysis, additional rate maximization actions and timely submission of excellent results to HEDIS® certified auditors and NCQA.