Tag Archives: care quality

Keys to managing the top 10 HEDIS challenges

A health plan’s Star Ratings and bottom-line performance depend heavily on improvements made to quality measures and Healthcare Effectiveness Data and Information Set (HEDIS®) scores. The key to boosting HEDIS scores and gaining competitive advantage is to be proactive and meet its challenges head on. But what exactly does that mean? We’ve identified the top […]
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Understanding the risks of incomplete medical coding

Information that could affect readmission risks, reimbursement, quality assessments and more is missing from medical records according to a recent study. MedPageToday reported on the study, conducted by researchers at Johns Hopkins University School of Medicine and published in November 2015 in the journal PLOS ONE. The researchers compared two large databases – one based on claims […]
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Health system id’s source of new ideas for reform

Proponents of Lean process improvements can’t seem to emphasize enough the importance of engaging all employees and empowering them to become problem solvers. Books, academic reports and articles all address the issue. Their message? Good ideas can come from anywhere – from a newly hired housekeeper to a ready-to-retire nurse manager. The CEO of a […]
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Documenting diagnoses makes a difference in care quality.

An often-repeated statistic warns that 8 million Americans have diabetes and don’t know it. There are similar claims about other chronic illnesses, like hypertension and chronic heart failure. If a patient doesn’t know they are missing a diagnosis, their health care provider may not either. The white paper Accurate coding: The foundation of accountable care explains that […]
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