To paraphrase the legendary Sun Tzu, 'a battle is won through proper preparation long before it has been fought'. HEDIS® Hybrid projects are no different. Although the 'battle' cannot be avoided, ensuring victory is very much possible.
As the stakes get bigger for HEDIS® projects every year, especially those with HEDIS Hybrid projects, complete and adequate planning and preparation are becoming imperative. HDVI has put together a checklist and a set of activities for these preparation tasks for its clients. All these preparation tasks should be completed prior to January 1, 2015.
- Verify HEDIS®-certified software vendors certfication
- Complete the NCQA HEDIS® Roadmap with your vendor and auditor
- Finish any HEDIS® Certified Vendor software implementations
- Review existing provider data for correct information and mapping
- Review provider network information with your vendor and develop collection strategies for large Medical groups or known problem providers
- Develop a plan to pre-notify providers to alert them that HEDIS® is approaching and to introduce vendor
- Create a sample selection for pediatric measures for early collection
- Select a sample and test provider and member data in MRR system to ensure data quality
- Test all interfaces between NCQA certified vendor and MRR vendor software before December 20
- Assess and fix any administrative data issues uncovered
- Cultivate a team approach between plan and vendors to ensure Hybrid sample data sets are completely correct the first time
- Develop a workplan outlining all aspects of the upcoming HEDI®S Hybrid or MRR including internal work as well as the roles of your vendors to perform proper oversight for MRR
- Share the workplan created with all relevant vendors to clarify roles and expectations
Download this list as a PDF >>