QIP/HEDIS

Health plans need to be comprehensive to truly address the needs of plan members. Employers taking health plans for their staff need to ensure that they take ones that cover all relevant aspects of their employees’ health so they are not faced with denied claims or other such issues. But just how do employers know whether they’ve taken the right plan for their staff? Outsource Strategies International (OSI) offers comprehensive HEDIS measurement and QIP solutions for health plans and healthcare providers.

Get in touch with us at (800) 670 2809 for a free HEDIS and QIP solutions consultation.

Relevance of 

HEDIS

HEDIS (Healthcare Effectiveness Data and Information Set) is a relevant standard that helps to measure the quality and effectiveness of a health plan. This standard of measures makes it possible for a health plan to be compared with other health plans and assessed objectively.

For Employers

It is a reliable means for employers to know the kind of care or provisions their employees will receive with a particular plan in relation to other plans in important areas of healthcare. HEDIS can enable employers to select the right plan for their staff, and thereby ensure their satisfaction.

For Health Plans

It also serves the needs of health plans. It helps insurance providers to improve their health plans with the help of the objective comparison data provided. They can make their product better and more competitive. HEDIS has been developed by the NCQA (National Committee for Quality Assurance), and is relied upon by over 90% of health plans in the United States for measuring their performance.

The areas of relevance covered include crucial matters of public health such as cancer, asthma, diabetes, smoking and heart disease. And when HEDIS reveals shortcomings in health plans, it is time to take up the QIP (Quality Improvement Program) to improve them.

HOW QIP HELPS

QIP is how health plans can be made more accommodating and useful, and the care areas improved. A good QIP can help improve the availability, accessibility, continuity, coordination and quality of the service offered to plan members. It also includes initiatives to avoid errors and ensure safety of the members. With the light shown by HEDIS standards, it could help make the health plan better. These measures provide the underlying guidelines for QIP initiatives.

HEDIS AND QIP SERVICES

at OSI

Our services are aimed at enabling insurers to meet NCQA quality goals and healthcare practices to improve their reimbursement. OSI’s in-depth knowledge of ICD and CPT codes as well as HEDIS reporting measures ensures quick evaluation of codes and compilation of medical charts. Our experience and expertise cover

  • Comprehensive diabetes care
  • Asthma medication use
  • Adult BMI Assessment
  • Controlling high blood pressure
  • Breast cancer screening
  • Cervical cancer screening
  • Fall risk management
  • Care for older adults
  • Persistence of beta blocker treatment after a heart attack
  • Advising smokers to quit
  • Immunization status
  • Childhood immunizations
  • Antidepressant medication management

We are fully equipped for ICD-10!

The advantages of OSI’s HEDIS coding and measurement services can be summarized as follows:

  • Absolute HIPAA compliance
  • On-time submission of HEDIS data
  • Quality compliance standards
  • Ongoing tracking and reporting
  • Free trial offer

OSI’s QIP services include designing programs for improving care and ensuring patient safety, improving the relevance of the health plan through better understanding of the demographic of its members, facilitating efforts to ensure and maintain regulatory compliance in line with NCQA accreditation and standards, and ensuring CMS as well as State and Federal regulatory compliance.

Turn to OSI for an absolutely Free trial of our services.