Blogs

HEDIS and Outreach

Disease Management is not dead… Contrary to some beliefs.  Disease management companies will be back stronger than ever. Why do you ask? Simply HEDIS performance improvement.  In order to show improvement you need to reach members to get those screenings, tests, and medication persistence.  A lot of companies ditched their DM vendors and in sourced their services as a way to save money and still keep their NCQA accreditation.  In the short term it made sense. There wasn’t much “value”  in just keeping a company around for QI8.  What a lot of plans don’t realize is that DM vendors provide tremendous value in moving HEDIS scores. They have the knowledge, infrastructure and programs already in place to touch those critical HEDIS concerns.  To be totally frank the NCQA DM program is basically a blue print on how to improve HEDIS scores. Here’s a little tidbit NCQA DM Performance measurements is linked to HEDIS, there a reason why they did this.  Think about it….  More on this later