Health Plan Effectiveness Data and Information Set (HEDIS®)
HMO and PPO
HEDIS measures are used to evaluate health plan performance in a number of domains, most importantly clinical quality. CCHRI facilitates the data collection process by coordinating the medical record review/copying between plans and medical groups minimizing the impact on groups and physicians of this very time intensive process. In return, medical groups sign agreements to assist with the record collection process. CCHRI provides training for individuals involved in chart reviews, provides an efficient cross-plan, centralized record pull list to the groups, and facilitates communications and project management for the process insuring that plans get the information they need in an organized, efficient and timely manner.
Thomson Healthcare Inc. staff work closely with CCHRI, managing the medical record collection process, providing Collector group training and technical expertise regarding HEDIS measurement.
CCHRI publishes cross-plan results in the CCHRI Report on Quality used by plans and purchasers and in an internal CCHRI report that is shared with CCHRI stakeholders. In addition, results are used as a component of eValue 8 health plan RFI. The Office of the Patient Advocate (OPA) depends on CCHRI as the source for HEDIS results published on their consumer website. In addition, OPA depends heavily on advice from CCHRI in its consumer reporting.
In response to strong purchaser interest CCHRI will be to collecting and reporting on PPO HEDIS scores for administrative data only measures in addition to HMO scores in 2008.
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