HEDIS AdvantageTM: The leading HEDIS® Measurement and Reporting Solution
MedAssurant is the market and technology leader for measuring and reporting on clinical and quality outcomes. HEDIS Advantage provides administrative data integration, medical record validation, and hybrid reporting for HEDIS reports, state-specific measure sets, and internally-developed quality measures.
With the powerful technology of Quality Spectrum Insight™ (QSI), an NCQA-certified software, expert administrative data integration, and a nationwide network of registered nurses for medical record reviews, MedAssurant has achieved perfect marks for successful implementations and no “Non-Report” audit findings. Supporting the data integration and analysis are dedicated project managers, each bringing experience as either a HEDIS auditor or as a HEDIS project manager at a health plan, and all having extensive understanding of the process, potential challenges, and proven solutions.
Aggregate data from multiple sources
To get the best scores and most accurate information, data is collected from multiple sources such as claims, labs, surveys, and patient records and then integrated to create a complete member profile for measurement encompassing a broader spectrum of accurate data.
Validate data to fill in gaps
Hybrid chart reviews are an integral part of quality measurement. MedAssurant has a nationwide network of registered nurses dedicated to medical record review. This in-market field staff of almost 3,000 reviewers touches more than 300,000 practitioners and 150,000 facilities, with the capability to complete 50,000 medical record and quality assurance reviews per day throughout 99.9% of all counties in all 50 states, Puerto Rico and the District of Columbia.
Inform through ongoing tracking and reporting
MedAssurant’s solutions for measuring and reporting quality go beyond HEDIS requirements providing a comprehensive catalogue of measures that includes state-specific measure sets. Our clients can create their own internal reports and model their own quality studies.
Improve member and provider knowledge
QSI has superior drill-down capabilities, offering clients full access to member-level detail. With this detail, clients can identify inaccurate claims data, non-compliant members, and compare provider groups.
Currently offered catalogue measures (besides HEDIS):
NY QARR
Florida AHCA
NCQA Pay for Performance
Medicare CMS Part C
Pennsylvania EQRO
PA PID 2011
California Healthy Families
Wisconsin BadgerCare Plus HMO Reporting
Nevada Medicaid HMO Reporting