More HEDIS fun facts

Sorry I've gotten behind in my posting. I went away for a wonderful long weekend to Stowe Vermont with my wife(no kids). So now its back to posting some more HEDIS Fun Facts.

HEDIS Fun Fact #5 CDC what does it stand for? If you said Centers for Disease Control you are warm but not right.  It stands for Comprehensive Diabetes Care. It's actually a bunch of sub measures under main measure.
The percentage of members 18–75 years of age with diabetes (type 1 and type 2) who had each of the following.

• Hemoglobin A1c (HbA1c) testing 
• HbA1c poor control (>9.0%) 
• HbA1c control (<8.0%) 
• HbA1c control (<7.0%) for a selected population
• Eye exam (retinal) performed 
• LDL-C screening LDL-C control (<100 mg/dL) 
• Medical attention for nephropathy 
• BP control (<140/80 mm Hg) 
• BP control (<140/90 mm Hg)

I personally find this one of the more interesting measures because of all the different  components.

HEDIS Fun Fact #6  How many different medicare programs are included for HEDIS reporting??  Correct answer is 6
HEDIS reporting is required for:

1. Medicare Advantage (MA) contracts 
2. Section 1876 cost contracts with active enrollment 
3. Medical Savings Account (MSA) plans 
4. Private Fee-for-Service (PFFS) plans 
5. Special Needs Plans (SNP) 
6. Certain demonstration projects.

 HEDIS Fun Fact #7 What is the  "Eligible Population"?  Coming from the definition from NCQA.  The eligible population for any measure is all members who satisfy all specified criteria, including age, continuous enrollment, benefit, event and the anchor date enrollment requirement.  The part to remember is that every individual measure has their own eligibility criteria.  It is very unwise to male a blanket decision for population. You will get burned in the long run.

HEDIS Fun Fact #8 What is "Continuous Enrollment"? No it is not the fee that you get charged monthly on your credit card you keep forgetting to cancel... Continuous enrollment specifies the minimum amount of time that a member must be enrolled in an organization before becoming eligible for a measure. Generally it is 12 months for HEDIS measures for the calendar year. However don't assume and check the specs

Ok that's all for Fun facts for today. Just remember "Don't assume, look up the darn spec!"