[{"innerBlocks":[],"name":"core\/freeform","postId":804,"blockType":{"name":"core\/freeform","keywords":[],"attributes":{"content":{"type":"string","source":"raw"},"lock":{"type":"object"}},"providesContext":[],"usesContext":[],"selectors":[],"supports":{"className":false,"customClassName":false,"reusable":false},"styles":[],"variations":[],"apiVersion":3,"title":"Classic","description":"Use the classic WordPress editor.","category":"text"},"originalContent":"The organization that creates the quality measures is digitizing them, leading to challenges for some large payer organizations that may find the transition difficult.

The National Committee for Quality Assurance (NCQA) is making the move to digitize its Healthcare Effectiveness Data and Information Set (HEDIS) measures, but payers that are large and set in their ways could be at a competitive disadvantage, some industry experts contend.

The evolution to digitized HEDIS measures will \u201cturbo-charge\u201d them, contends John D\u2019Amore, a technical advisor to NCQA and president and chief strategy officer of Farmington, Conn.-based Diameter Health, a company that cleanses medical data.

With this digitization of HEDIS measures, some health plans will remain \u201ctoo baked in their ways\u201d and will continue to collect the data as they have done for 20 years, he predicts, and that\u2019s what could leave them at a competitive disadvantage.

Most big payers are aware of the upcoming digitization and are planning ahead, D\u2019Amore says. \u201cOur experience is that the clinical data acquisition strategies of larger firms tend to be more mature,\u201d he adds. Larger plans have the scale to tackle the transition, and some have already started discussions about data acquisition with health systems, health information exchanges and electronic health record vendors.

In addition, more experienced firms are developing data use agreements that span multiple use cases, instead of negotiating agreements for just one use case. \u201cAs scalable clinical data integration accelerates, smaller and middle-sized plans will need to adopt these competencies, as well,\u201d D\u2019Amore says.

Once all the big payers have moved to digital HEDIS, it could make the health payers that don\u2019t collect data this way look bad in comparison, D\u2019Amore warns.

\u201cClinical data collection is already raising the bar for HEDIS reporting, and payers will need to report better scores just to stay in the same relative position,\u201d he says. \u201cClinical data is also beginning to make its presence felt in risk adjustment, care coordination and advanced analytics. Having the right data at the right time in the right place can help the care team make the right decision for a patient to improve the outcome and avoid unnecessary expense.\u201d

The continuing transition toward value-based contracts with providers will put increasing demands on quality reporting, according to D\u2019Amore. Quality reporting itself is in the process of transitioning from a hybrid paper-digital process to something that\u2019s electronic from end-to-end.

Reporting quality as a byproduct of providing care\u2014that is, using electronic clinical quality measures, rather than as a separate and often manual business process\u2014is really the only way to provide better care and drive cost out of the system, D\u2019Amore contends.

Health plans have traditionally relied on claims data for assessing quality, but they will increasingly need to incorporate clinical data into their reporting for HEDIS, he says. Risk sharing arrangements between payers and providers will help to eliminate some of the barriers that health plans currently face in acquiring clinical data.

According to NCQA, the next generation of HEDIS digital quality measures will:

\u00b7 Align quality measures across the healthcare system.
\u00b7 Reduce the burden associated with measurement and reporting.
\u00b7 Reduce costs of implementing and updating measures.
\u00b7 Improve accuracy and validity of measure calculations and reporting.
\u00b7 Provide flexibility in use of HEDIS measures.
\u00b7 Enhance value for health plans.
\u00b7 Build the foundation for new outcome measures.

With the release of CMS\u2019s 2017 Meaningful Measures Initiative and NCQA\u2019s recently released roadmap, ultimately, NCQA and CMS are hoping to sync up their goals, says Alec Bose, a spokesman for NCQA in his recent blog, entitled, \"CMS Meaningful Measures-NCQA\u2019s Digital Measures Roadmap: What\u2019s the Connection?\"

Bose says NCQA\u2019s plan to digitize HEDIS measures will make them more meaningful, improve measurement accuracy and reduce reporting burden, which, in turn, will lower costs and reduce effort, creating what he calls, \u201cthe HEDIS of the future.\u201d

NCQA released six digital or machine-readable measures and kicked off the HEDIS Electronic Clinical Data System (EDCS) Reporting last year. Each year over the next three years, it plans to convert between 20 and 25 additional HEDIS measures as part of its strategic plan.

This year, NCQA is providing a package of eight digital measures for traditional reporting and a package of eleven digital measures for ECDS reporting, including depression screening and follow-up for adolescents and adults; utilization of the PHQ-9 to monitor depression symptoms for adolescents and adults; depression remission or response for adolescents and adults; unhealthy alcohol use screening and follow-up; adult immunization status; and prenatal immunization status.","saveContent":"The organization that creates the quality measures is digitizing them, leading to challenges for some large payer organizations that may find the transition difficult.

The National Committee for Quality Assurance (NCQA) is making the move to digitize its Healthcare Effectiveness Data and Information Set (HEDIS) measures, but payers that are large and set in their ways could be at a competitive disadvantage, some industry experts contend.

The evolution to digitized HEDIS measures will \u201cturbo-charge\u201d them, contends John D\u2019Amore, a technical advisor to NCQA and president and chief strategy officer of Farmington, Conn.-based Diameter Health, a company that cleanses medical data.

With this digitization of HEDIS measures, some health plans will remain \u201ctoo baked in their ways\u201d and will continue to collect the data as they have done for 20 years, he predicts, and that\u2019s what could leave them at a competitive disadvantage.

Most big payers are aware of the upcoming digitization and are planning ahead, D\u2019Amore says. \u201cOur experience is that the clinical data acquisition strategies of larger firms tend to be more mature,\u201d he adds. Larger plans have the scale to tackle the transition, and some have already started discussions about data acquisition with health systems, health information exchanges and electronic health record vendors.

In addition, more experienced firms are developing data use agreements that span multiple use cases, instead of negotiating agreements for just one use case. \u201cAs scalable clinical data integration accelerates, smaller and middle-sized plans will need to adopt these competencies, as well,\u201d D\u2019Amore says.

Once all the big payers have moved to digital HEDIS, it could make the health payers that don\u2019t collect data this way look bad in comparison, D\u2019Amore warns.

\u201cClinical data collection is already raising the bar for HEDIS reporting, and payers will need to report better scores just to stay in the same relative position,\u201d he says. \u201cClinical data is also beginning to make its presence felt in risk adjustment, care coordination and advanced analytics. Having the right data at the right time in the right place can help the care team make the right decision for a patient to improve the outcome and avoid unnecessary expense.\u201d

The continuing transition toward value-based contracts with providers will put increasing demands on quality reporting, according to D\u2019Amore. Quality reporting itself is in the process of transitioning from a hybrid paper-digital process to something that\u2019s electronic from end-to-end.

Reporting quality as a byproduct of providing care\u2014that is, using electronic clinical quality measures, rather than as a separate and often manual business process\u2014is really the only way to provide better care and drive cost out of the system, D\u2019Amore contends.

Health plans have traditionally relied on claims data for assessing quality, but they will increasingly need to incorporate clinical data into their reporting for HEDIS, he says. Risk sharing arrangements between payers and providers will help to eliminate some of the barriers that health plans currently face in acquiring clinical data.

According to NCQA, the next generation of HEDIS digital quality measures will:

\u00b7 Align quality measures across the healthcare system.
\u00b7 Reduce the burden associated with measurement and reporting.
\u00b7 Reduce costs of implementing and updating measures.
\u00b7 Improve accuracy and validity of measure calculations and reporting.
\u00b7 Provide flexibility in use of HEDIS measures.
\u00b7 Enhance value for health plans.
\u00b7 Build the foundation for new outcome measures.

With the release of CMS\u2019s 2017 Meaningful Measures Initiative and NCQA\u2019s recently released roadmap, ultimately, NCQA and CMS are hoping to sync up their goals, says Alec Bose, a spokesman for NCQA in his recent blog, entitled, \"CMS Meaningful Measures-NCQA\u2019s Digital Measures Roadmap: What\u2019s the Connection?\"

Bose says NCQA\u2019s plan to digitize HEDIS measures will make them more meaningful, improve measurement accuracy and reduce reporting burden, which, in turn, will lower costs and reduce effort, creating what he calls, \u201cthe HEDIS of the future.\u201d

NCQA released six digital or machine-readable measures and kicked off the HEDIS Electronic Clinical Data System (EDCS) Reporting last year. Each year over the next three years, it plans to convert between 20 and 25 additional HEDIS measures as part of its strategic plan.

This year, NCQA is providing a package of eight digital measures for traditional reporting and a package of eleven digital measures for ECDS reporting, including depression screening and follow-up for adolescents and adults; utilization of the PHQ-9 to monitor depression symptoms for adolescents and adults; depression remission or response for adolescents and adults; unhealthy alcohol use screening and follow-up; adult immunization status; and prenatal immunization status.","order":0,"get_parent":{},"attributes":[],"attributesType":{"content":{"type":"string","source":"raw"},"lock":{"type":"object"}},"dynamicContent":""}]

Health plans to go digital with HEDIS, expert says

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