Health plans have 1 more year to hike HEDIS marks
Health plans have 1 more year to hike HEDIS marks
Health plans will have one more year to boost their Health Plan Employer Data and Information Set (HEDIS) scores before they become a critical part of accreditation decisions, the National Committee for Quality Assurance (NCQA) in Washington, DC, announced.
Accreditation 99 still requires plans to report audited data on HEDIS measures, including immunization and mammography rates and other clinical process items, member satisfaction, and access. Favorable HEDIS scores can boost the plan's overall accreditation score, but weak scores can't harm it until the year 2000, says NCQA spokesman Barry Scholl.
NCQA also revealed a new format for reporting health plan performance to the public. The chart resembles one from the magazine Consumer Reports, using circles that are fully shaded, half shaded, or merely outlined to indicate high, average, or lower than average performance.
The report's categories comprise overall ratings for: Access and Service, Qualified Providers, Staying Healthy, Getting Better, and Living with Illness. Plans can receive one of five accreditation designations: excellent, commendable, accredited, provisional, or denied.n
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