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, including for MRR or 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. Some of the highlights include:
- Verify vendor NCQA certification
- 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 HEDIS 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
To learn more about how HDVI supports customers with these and other critical aspects of MRR projects, contact us here.