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Maximum HEDIS™

Maximum HEDIS™. Getting The Most Out of Health Plan Performance Measurement. What is “Maximum HEDIS ™ ”?. Getting Every Possible Fraction of a Point for.. Highest Possible HEDIS rates that represent performance Lower Costs to deliver Highest Possible HEDIS (MRR)

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Maximum HEDIS™

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  1. Maximum HEDIS™ Getting The Most Out of Health Plan Performance Measurement

  2. What is “Maximum HEDIS™”? Getting Every Possible Fraction of a Point for.. • Highest Possible HEDIS rates that represent performance • Lower Costs to deliver Highest Possible HEDIS (MRR) • Maximize HEDIS scores statistically in accordance with NCQA specs • Higher reportable scores Over and Above underlying performance changes

  3. Why Does Maximum HEDIS Matter? • Market Competition (Low Scores Cost Members) • “Performance Guarantees” (Low Scores Cost $$) • Narrowing “Performance Gap” (High Rankings Harder to get) • Indirect Savings (Higher Scores May Offer Relief) • Accreditation Banding (eg “Excellent” vs “Commendable”) • Without “Maximum HEDIS”, scores lower!

  4. How to Get the Results You Want The Key: Sampling Error in Hybrid Measures • Sampling Error (SE) does NOT “come out in the wash” – the effect of SE is profound! • Adverse SE hurts EVERY plan – unavoidable, but manageable* • NCQA allows flexibility in sampling options • *Model every allowable option (36) then select best • Complement with a Focused MRR Strategy *only with MOSES™ Software

  5. MOSES™: The Performance Measurement Toolkit • MOdeling of Sampling Error Scenarios • Simultaneously compares all 36 sampling alternatives allowed under NCQA • ANY Hybrid Measure (plus some EOC-Like Measures!) • Easy – requires NO extra work! • Quick – Instant Sample Extracts, Calculations • Shows MRR and Direct Savings • Audit Trigger Alert • Oversample “Runs” • HEDIS Sampler & Encryption SW included FREE!

  6. MOSES™ For Further Information about MAXIMUM HEDIS™ with MOSES™ Software, Contact Health Care Quality Metrix at: HCQM 162 Circuit Road Boston, MA 02152 (617) 249-1757 moses@hcqm.com www. hcqm.com

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