Medicaid Plan Improves Key HEDIS® Scores by 4% Year-Over-Year with the Affinitē™ Platform’s ProviderLink™ and Quality Modules

In Affinite Quality, Care Coordination, Care Management, Healthcare, HEDIS & Quality Management by Marketing

Empowers Providers With Real-Time Quality Score
Performance and Streamlines Care Gap Closure

A non-profit, community-based Medicaid plan selected Vital Data Technology’s Affinitē™ platform to communicate timely, targeted care gap interventions to physicians. Since the payer is affiliated with a children’s hospital and it offers STAR Medicaid, STAR Kids, CHIP, and CHIP Perinatal, improving provider compliance with Annual Well Child Visit measures targeting adolescents and younger patients were top priorities.

Affinitē’s Quality and ProviderLink™ modules made it possible for the health plan to automatically prioritize HEDIS® quality measure interventions for each of their providers’ patients. This process was formerly manual and required multiple calls and faxes back and forth between the health plan and providers. Now, these interventions, as well as medical record updates made by physicians, are communicated instantly through Affinitē™. The health plan can track the performance of quality targets for provider groups down to individual physicians, thereby accelerating quality improvement.

When logged into Affinitē’s ProviderLink™ module, Providers see complete case management history, clinical, lab, pharmacy, emergency department, and other encounters, even outside of their network. Providers leveraged this 360° view of their members’ health to stay on top of key interventions with patients and send medical record updates to the health plan with one click. This seamless data integration reduces the number of medical record requests required during “HEDIS® season,” and it reduces the risk of causing provider abrasion throughout the year.

HEDIS® Measure Performance Improvements Realized by Providers Using Affinitē™ 

Affinitē had a powerful impact on Annual Well Child Visit measures as providers were able to rapidly close care gaps, exceeding the health plan’s targeted outcomes.

Annual Well Child Visits for adolescents 12-21 (AWC) 

  • 32% increase in compliant patient count
  • 9% higher overall scores were achieved by providers using Affinitē 
  • 4% year-over-year improvement of overall score

Annual Well Child Visit for children 3-6 (W34) 

  • 14% increase in compliant patient count
  • 5% higher overall scores were realized by providers using Affinitē 
  • 3% year-over-year improvement of overall score

Six Office Well Child Visits from 0 – 15 months (W15)

  • 8% higher overall scores were achieved by providers using Affinitē 
  • 4% year-over-year improvement of overall score

“Working with Vital Data Technology has improved our capability to communicate targeted care gap interventions to physicians. This is beneficial to our members and physicians,” 

Chief Executive Officer, Medicaid Health Plan

Achieve Higher HEDIS® Scores by Empowering Providers with Affinitē  

This case study highlights the value in seamlessly aligning providers with the health plan’s quality goals by alleviating manual, repetitive tasks. By giving providers access to real-time quality score performance data by measure and member,  the plan quickly found that the providers took action to improve on their scores, ultimately benefiting the plan, the provider, and the member.  

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