Case Study: Midwest Health Plan

Dramatically improved NCQA ranking
Midwest Health Plan used our HEDIS solution to implement year-round compliance tracking and analysis. The plan proactively identified quality issues well before the NCQA submission deadline and engaged members and providers in its quality improvement processes. The year-round efforts resulted in improved compliance across the board. The plan raised its NCQA ranking and gained a competitive advantage in the Medicaid Managed Care Market. To learn more, read the Midwest Health Plan Case Study.

Client Anecdotes:

“The system is user friendly, the data is accurate and you have provided us with everything that we need to excel. Thank you guys!”

"We had our nurses' end-of-HEDIS luncheon today and they all commented that Quality Reporter is so much better than the HEDIS software we used last year."

"I am in the process of assigning chases to the nurse reviewers. I cannot begin to tell you how much simpler this process is compared to what we did last year with [other software vendor]! This product is awesome! And so are all of you at Verisk Health who are there for us every time we need you! A great big thanks!"

The Solution: HEDIS Management

Features

  • Dynamic analytic and reporting capabilities, including functionality to drill down to member-level and claim detail
  • Best in industry chase logic includes ability to target prescribing physicians. Custom chase logic is available
  • Comprehensive built-in pursuit and chart review functionality
  • Integrated retrieval and abstraction services performed by experienced clinical staff
  • Engage members and providers with customizable outreach letters and performance score cards
  • Access to a secure, online collaboration tool to facilitate communication, planning and project management of your HEDIS project
  • Fully integrated with our STARS Navigator solution

Benefits

  • Report and submit HEDIS administrative and medical record data quickly and easily
  • Improve compliance with HEDIS measures and other quality metrics
  • Develop, implement and measure internal quality improvement initiatives
  • Prospectively measure rates at the member, provider and employer group level
  • Real-time tracking of chart review progress
  • Optimize Medical Record Review (MRR) hits more efficiently and effectively
  • No need for multiple vendors; save time and money leveraging our single source solution for all your regulatory submission requirements and quality improvement initiatives
  • A dedicated partner to support you every step of the way

Next Steps

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