The Center for Beneficiary Choices (CBC), Centers for Medicare & Medicaid Services (CMS) needed a company to support CMS in the annual data collection, management, and analysis of Health Effectiveness Data & Information Set (HEDIS®) Medicare patient-level quality of care measures. The final analysis included ranking Medicare health plans to allow CMS to distribute appropriate reimbursement to the health plans.
HCDI was required to receive a data file from all qualified Medicare health plans and to ensure the accuracy of the data submitted within a very tight timeframe. This involved giving feedback to plans whose data submissions were not accurate and assisting their programmers in correcting the layout used for the data submission. Once all files had been received, a report to rank the plans on their HEDIS rates using criteria was developed by teaming with CMS. This was forwarded to CMS for final dispersal of funds.
As the HEDIS measures differed from year to year, it was necessary to include new measures and delete measures that became obsolete. This required changing the documentation of the required measures to be updated and submitted to health plans participating in the project. It also required updating our custom developed databases, processing applications, and Web portals associated with data collection in order to accommodate the annual changes in the files and facilitate data collection and support.
CMS used the information submitted by HCDI to reimburse the health plans and extended the contract with HCDI for four additional years.
The following case studies are from some of our most recent and interesting projects. These case studies highlight the interdiscplinary collaborations within our Firm.
- Research and Analysis
- Web Development
- Integrated Information System Solutions
- National Committee for Quality Assurance - NCQA