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Answers to HEDIS® Tech Spec Questions

In Affinite Quality, HEDIS & Quality Management by Marketing

All in all, NCQA’s comprehensive updates to dozens of HEDIS® technical specifications will create better outcomes and more actionable data insights. Health plan quality, billing, and outreach professionals, however, have raised a few reporting and implementation questions. Many of these questions concern when new measurements take effect, which have been revised, and which no longer must be included in plan …

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NCQA Recommendations to Transform Telehealth, HEDIS®, and Data Analysis

In Affinite Quality, HEDIS & Quality Management by Marketing

Recognizing that technology has caught up and evolving circumstances necessitate new initiatives, NCQA’s Taskforce on Telehealth Policy has developed a host of policy recommendations surrounding the use of telemedicine. As telehealth initiatives continue to expand, it will create more and more data that health plans can use to inform care decisions, improve member outreach, maximize revenues, and streamline operations. Vital …

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Data Science Tools Improve COVID-19 Care for Those Vulnerable to Social Determinants of Health Factors

In Affinite PlanLink, Care Management, Covid-19 by Marketing

Key Benefits Include Outreach, Education, Prioritization Last month, we discussed how strong data analysis can help care managers identify patients who are at greater risk from COVID-19 owing to social determinants of health (SDoH). SDoH, the societal, demographic, and economic variables that affect a person’s wellbeing, include access to healthcare, where they live and work, the availability and affordability of …

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The Benefits of Bringing Risk Adjustment In-House

In Affinite Risk, Risk Adjustment by Marketing

Benefit #1 Improved ROI We’ve recently published a series of blog posts focused on the challenges of bringing risk adjustment in-house. The series is pivoting, and the next few posts will examine the benefits of this effort. One of the most significant benefits of bringing risk adjustment in house is having tighter control over your return on investment (ROI). ROI …

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NCQA Finalizes HEDIS® Telehealth Framework, Goals and Resources

In Affinite Quality, Covid-19, HEDIS & Quality Management by Marketing

As I noted in a previous blog post, NCQA has acted swiftly to adjust HEDIS® requirements to reflect the treatment and outreach challenges presented by COVID-10. Striving to limit healthcare professionals’ exposure to the virus, the new guidelines for outpatient care through video and telephone calls and readings from in-home monitors. Self-isolation recommendations and many patients’ reluctance to travel for …