NCQA has simply launched its 2023 well being plan scores. These scores are primarily based on well being plans that publicly report their high quality measures (through the Healthcare Effectiveness Knowledge and Data Set – HEDIS®) and represents about two thirds of your entire US inhabitants.
Total, there’s a slight enchancment in efficiency from well being plans versus 2022 – particularly round well being fairness – the place 92% of plans reported the direct race and ethnicity measure – scoring most factors on this measure.
Two business plans acquired 5-star scores – Kaiser Basis Well being Plan of the Mid-Atlantic States and Impartial Well being Affiliation (which is up from 1 plan final 12 months). No Medicare or Medicaid plans acquired 5 stars this 12 months.
With these scores now launched, we are going to eagerly anticipate the October launch of 2023 Stars scores to see if drop in efficiency final 12 months was a “blip”, with restoration this 12 months or if extra plans will see the put up covid influence on their scores.
No matter total traits, if you’re a well being plan trying maximize your scores, my robust recommendation is that you just flip to know-how and AI options to make sure you are reporting precisely – and never being penalized for care gaps that exist on paper however not in follow.
How do you do that? With AI assisted medical document evaluation – as a well being plan, you may improve the amount and accuracy of supplemental information or digital information you evaluation and submit as a part of your high quality reporting. This use of such know-how has seen well being plans and ACOs improve effectivity of medical document reconciliation and evaluation by over 10x.
As we method HEDIS® season – it is not too late to make the increase you want with NLP.
If that is of curiosity to you – then please get in touch.
21 Sep 2023