Quality, in healthcare, is the process of using data to evaluate the performance of the health care providers against recognized quality standard measures. This is a necessary step in the process of improving health care quality.
In the United States, two nonprofit groups dominate the performance-measurement field. The National Committee for Quality Assurance accredits health plans, provider groups, and various medical businesses. The Joint Commission focuses on hospitals, laboratories, and many types of medical institutions. The Joint Commission and NCQA measure quality in different ways.
Healthcare effectiveness and information data set (HEDIS) is a widely used set of performance measures in the managed care industry – developed and maintained by the National Committee for Quality Assurance (NCQA). HEDIS measures how well health plans give service and care to their members.
HOM assures quality by establishing profitability benchmarks according to the nature of your organization. In addition to that, these benchmarks also help in recognizing loopholes and areas which need special attention. We use our set of measures whilst evaluating the Revenue Cycle Management of your healthcare facility. These measures are like performance audits to eliminate even the minutest of errors.
We at HOM understand the daily demands of patient care. Whether you’re a group practice, an IPA, or a single provider office, HOM’s quality management service can track performance and productivity.
HEDIS Measures
At HOM, we work on NCQA developed HEDIS measures including the following:
A. Prevention and Screening Measures
- Breast Cancer Screening
- Advance Care Planning
- Colorectal Cancer Screening
- Medication Review (COA)
- Functional Status Assessment (COA)
- Pain Assessment (COA)
- Controlling High Blood Pressure
- Retinal Eye Exam (CDC)
- HbA1c Poor Control (>9.0%) (CDC)
- FMC (Follow-up after ER visit for high-risk patients)
- KED (Kidney Health Evaluation in Adults for Diabetes)
- Medication Reconciliation Post Discharge (MRP)
- TRC-Patient Engagement
B. Medication-Based Measures
- OMW: Osteoporosis Management in Women
- SPC: Statin Therapy for CVD
Our Tech
Our technology enables seamless operations and improves procedural efficiency reducing processing time by up to 50% and resulting in higher satisfaction.
A robust system to collect, track and maintain data through the latest technology and infrastructure.
All verification and legitimization processes comply with NCQA, URAC, and JCAHO standards.
Highest productivity and quality standards with competitive pricing.
Secure storage of all documents on the client’s server, less chance of a breach.
More acquainted with payor requirements for the credentialing.
Our Edge
Interactive, user-friendly dashboard with real time updates.
Submission capability for multiple quality initiatives across different plans.
Real-time tracking of productivity and performance.
HEDIS Chart review and submission.
Direct submission of compliant docs to the plans resulting in increased efficiency.
In-house team of auditors ensuring quality SLAs are met by involved parties.
120k+
gaps reviewed in an year.
Improved ratings of
50+ PCPs
99%+
quality accuracy