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NCQA publishes proposed changes to HEDIS measures for MY …

NCQA is looking for public comments on these new proposed HEDIS measures, updates to existing measures, proposed measure retirements, … See more

Actived: 7 days ago

URL: https://blog.cotiviti.com/ncqa-publishes-proposed-changes-to-hedis-measures-for-my-2023

CMS 2023 Advance Notice: Health equity takes center stage

WEBHealth equity initiatives are increasingly playing a crucial role in CMS programs as a whole, and come on the heels of a major push by the National Committee …

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3 areas of investment for payers to improve health …

WEBAs the Centers for Medicare & Medicaid Services (CMS) prioritizes health equity in Star Ratings and the Office of the National Coordinator for Health Information Technology (ONC) advocates for “health equity by design,” …

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Learning from 2022 Star Ratings and planning for 2023–2024

WEB1 plan improved from 3.5 to 5 stars. 52 plans (85% of eligible clients) achieved a 4-star rating or higher. 0% of eligible client plans achieved a lower rating than in 2021. But …

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White paper: Detecting and preventing FWA in behavioral health …

WEBSince the COVID-19 pandemic began, telehealth has been a key factor in treating behavioral health issues. In 2021, more than 30% of surveyed adults reported …

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Podcast: Cotiviti SVP Rachael Jones on health equity strategy

WEBListen to Rachael’s interview as she discusses how to: Develop a data-driven strategy to begin addressing health equity. Identify the barriers to health equity beyond race, …

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What’s old is new again: 3 healthcare fraud trends to

WEBAs the health system bent under the weight of the COVID-19 pandemic, bad actors used this opportunity to devise schemes to extract money from the system through fraud, …

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4 strategies to curb medical cost increases as healthcare

WEBWhen the COVID-19 pandemic accelerated rapidly in early 2020, the impact on healthcare utilization was sharp, dropping nearly 32% in April 2020 as both providers and healthcare consumers quickly moved to delay or cancel elective procedures. As noted by the Peterson-KFF Health System Tracker, this continued into 2021, with …

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5 tips for improving and sustaining member satisfaction

WEBConsumer satisfaction is a year-round effort and is impacted by a member’s complete experience with the health care ecosystem, including moments in the doctor’s office, …

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FWA Insights: Catching schemes related to Ozempic, Wegovy, and …

WEBAs new drugs such as Ozempic are continually introduced in the marketplace, health plan SIUs can struggle to keep up. Get help from Cotiviti’s FWA Management …

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Q&A: Highmark's payment integrity director on new COVID-19

WEBThe FAIR Health organization is showing a 4,000 percent increase in telehealth visits and a 30 to 40 percent increase in telehealth usage for infectious …

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Full steam ahead: CMS finalizes new condition count model

WEBFor example, America’s Health Insurance Plans (AHIP) and the Blue Cross Blue Shield Association (BCBSA) both recently submitted letters to CMS supporting the use of encounter data, but requesting that the agency slow the transition until operational problems and uncertainties have been resolved. Time to take action

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Data lakes: the rising tide that lifts all healthcare stakeholders

WEBWith the excitement around data lakes continuing to build, I look forward to at the 2019 Health Datapalooza coming up March 27 and 28 in Washington, D.C., where I’ll be …

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CMS Star Ratings: Navigating changes in 2021 and the coming

WEBAs many health plans know, achieving a higher Star Rating will soon be more challenging. The Centers for Medicare & Medicaid Services (CMS) is changing the makeup of the rating system, with two changes to patient experience weighting set to take place in 2021 and 2023, respectively. For 2021 Star Ratings, CMS has increased the relative

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Analysis: Behavioral health conditions, risk, and cost

WEBAnalysis: Behavioral health conditions, risk, and cost during the COVID-19 pandemic. As millions of people found themselves out of work or isolated from loved ones during the …

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Podcast: Welcoming, onboarding, and retaining members in the

WEBA new year will soon be upon us, bringing a flurry of health plan activities with it. This includes new member welcome and onboarding, transition of care support, primary care …

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Podcast: Improving risk assessment for better care outcomes

WEBPodcast: Improving risk assessment for better care outcomes. Accurate risk assessment improves results for health plans across a multitude of areas, including member care, …

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HEDIS MY 2023: Noteworthy topics to consider during NCQA’s

WEBThe National Committee for Quality Assurance (NCQA) has released proposed updates and changes to HEDIS ® measures for Measurement Year 2023 (MY 2023) for public …

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Cotiviti achieves 20 years of HEDIS® certification amid expanding

WEBTo build a successful quality improvement program, health plans not only must stay ahead of annual changes to HEDIS ® reporting requirements, but also a continually expanding list of state and other custom measures to track as well. Amid all this change, Cotiviti’s Quality Intelligence solution recently earned full certification for its Quality Engine application …

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NCQA publishes proposed changes to HEDIS measures for MY …

WEBNCQA is proposing to introduce race and ethnicity stratifications to five HEDIS measures for MY 2022 with an expansion to a minimum of 15 measures by MY 2024 to help identify …

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Case study: Accelerating value-driven care through provider

WEBThat’s why one major health plan in North Carolina, serving nearly 4 million members across the state’s 100 counties, took action in recent years to implement a …

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Case study: How Health Partners Plans recovered a >$1M

WEBOur new case study details how Health Partners Plans, a not-for-profit managed care organization serving more than 258,000 Medicaid, Medicare, and CHIP members in …

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