Hedis and Outreach
Michael’s comment sparked a few neurons for me so I’m going to digress a tiny bit. PCMH (Patient Centered Medical Homes) is a very popular buzzword. NCQA has this program that can be accredited. It’s a pretty good program to be honest. It really tries to get practices to use technology to improve health care. It focuses a lot on EHR’s (Electronic Health Records). They really want practices to think about population health and management. They do the typical quality improvement language (Quality measures) which will transmit into HEDIS measures being used. The one weakness with this is that the population will have multiple HMO coverage’s (there are very few single HMO practices out there as far as I know). So you could have 3 different patients with different coverage’s. All these plans could have different requirements…. It’s really a mess the practice to keep it straight. Plus who the heck is going to do the quality metrics for these practices?? The medical billing coder? This is where the DM companies need to work hand in hand with the practices. They need tie the practice outreach with the DM outreach. This is a huge opportunity for the DM companies. Do you really think the HMO is going to do this??They already are doing the metrics, they have the outreach capability. Just how do you tie this together? You need to tie the EHR, the doctor and the disease management together. You need the doctor to feed the EHR, the EHR to feed the DM and the DM to feed the EHR. Sounds easy, doesn’t it?There are very few companies that I know of that can do this at this moment.
I got some really nice email feedback from some readers. So I’ll do some running posts about HEDIS in general. A bit of a 101 type on Thursday.
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