CHNCT relies on the data collected from CMAP providers to comply with HEDIS®. In January of each year, randomly selected providers will receive a medical record review letter outlining the process, along with an instruction sheet. Medical record data collection will begin in February, and continue into May. The sooner that practices provide requested clinical information, the smoother the process will go. Show
If your practice is interested in setting up an arrangement by which CHNCT can access your Electronic Health Record (EHR) remotely to obtain records, please contact us at 1.866.317.3301. Alternatively, your practice can send the requested records securely by fax to CHNCT’s dedicated fax line at 203.265.2945; via email to
; or via regular mail to: If your practice stores medical records in a central location and would like CHNCT to address all requests for medical records to that location, please let us know right away. You can contact us by email at or by phone at 1.866.317.3301 Monday - Friday, from 8:00 a.m. to 5:00 p.m.; a voicemail is available after hours. HEDIS MeasuresCMS contracted with NCQA to develop a strategy to evaluate the quality of care provided by SNPs. NCQA established Healthcare Effectiveness Data and Information Set (HEDIS) measures specifically for SNPs. HEDIS is a comprehensive set of standardized performance measures designed to provide purchasers and consumers with the information they need for reliable comparison of health plan performance. HEDIS Measures relate to many significant public health issues, such as cancer, heart disease, smoking, asthma, and diabetes. SNPs can use HEDIS performance data to identify opportunities for improvement, monitor the success of quality improvement initiatives, track improvement, and provide a set of measurement standards that allow comparison with other plans. Data allow identification of performance gaps and establishment of realistic targets for improvement. SNPs reported the following measures in HEDIS 2016:
Please see the links below for the most recent SNP HEDIS Reports released by NCQA. You can use two well-established health plan measurement sets as the basis for collecting data and preparing comparative information for your audience: These
measures have been endorsed by the National Quality Forum, a multistakeholder organization established to standardize health care quality measurement and reporting. Learn about the National Quality Forum. HEDIS refers to a widely used set of performance measures in the managed care industry. More than 90 percent of health
plans—HMOs, POS plans, and PPOs—use HEDIS to measure performance. HEDIS is managed by the National Committee for Quality Assurance (NCQA), a private, non-profit organization that accredits and certifies health care organizations. HEDIS is one component of NCQA's accreditation process, although some plans submit HEDIS data without seeking accreditation. Learn about the
NCQA. HEDIS enables consumers and purchasers to compare health plan performance to other plans and to national or regional benchmarks. Consisting of over 70 measures of process, structure, and outcomes, HEDIS addresses a spectrum of care from prevention to acute to chronic care. It also encompasses health plan members’ assessments of their experiences with care as measured by the CAHPS Health Plan Survey (described below). NCQA adds, deletes, and revises HEDIS measures annually. HEDIS scores are regarded as highly credible, in part because an NCQA-approved auditing firm must validate results. Also, an NCQA-approved external survey organization must administer the CAHPS survey when it is part of a health plan’s HEDIS submission to NCQA. Data source: You can obtain HEDIS results directly from health plans or by purchasing access to NCQA’s Quality Compass® database of health plan performance results. More details about Quality Compass are provided in Databases Used for Health Plan Quality Measures. For more information about HEDIS or to purchase HEDIS publications, visit NCQA’s Web site at http://www.ncqa.org. CAHPS® Health Plan SurveyCAHPS refers to a family of standardized surveys that can be used to gather and report information on consumers’ experiences with health plans and providers. The surveys are developed and supported by a consortium of researchers with funding from the Agency for Healthcare Research and Quality (AHRQ). The CAHPS Health Plan Survey consists of over 40 items that ask the respondent to rate their experiences with different aspects of care, including access, timeliness, communication, courtesy, and administrative ease. Instruments are available for adults and children in commercial, Medicaid, and Medicare populations. Data source: Some sponsors generate CAHPS data by surveying their own audiences (e.g., employees, beneficiaries); however, sponsors typically get this information directly from the health plans or from NCQA because results from this CAHPS survey are incorporated into HEDIS. For more information about the survey, visit the CAHPS Web site. Also in "Measures of Health Plan Quality"
Which is responsible for reviewing health care provided by managed care organizations?CMS is responsible for reviewing and approving state requests to implement managed care under these authorities. All Medicaid managed care programs, regardless of authority, are subject to the provisions of Section 1932 and 42 CFR 438 unless specifically waived.
Which program was implemented so that quality assurance activities?MANAGED HEALTH CARE. Which type of HMO where health care services are provided to subscribers by physicians employed by the HMO?Also called independent practice association (IPA) HMO, contracted health services are delivered to subscribers by physicians who remain in their independence office settings.
Which is the process that a facility undergoes to demonstrate that it meets standards beyond?Managed Health Care. Voluntary process that a healthcare facility or organization undergoes to demonstrate that it has met standards beyond those required by law.
|
Performance measures developed by NCQA and used to evaluate managed care plans are found in the
zusammenhängende Posts
Urheberrechte © © 2024 paraquee Inc.
