Spring 2009
2009 HEDIS study under way
Blue Cross and Blue Shield of Florida’s HMO subsidiary, Health Options, began conducting its 2009 Healthcare Effectiveness Data and Information Set (HEDIS®) study in provider offices in March. The National Committee for Quality Assurance (NCQA®) uses HEDIS measures to provide a consistent method for consumers to evaluate the effectiveness of various health plans. HEDIS measures are an important part of our Quality Improvement program and Health Options’ NCQA accreditation score.
BlueCare and BlueMedicareSM HMO members are randomly selected for participation in these studies. Therefore, medical record reviews are not conducted in all physician offices. If some of your members are part of the random sample, you will receive a request from Health Options’ contracted vendor, MedAssurant, Inc., to schedule an onsite visit. The MedAssurant representative will review selected medical record(s) and scan appropriate supporting documentation. Blue Cross and Blue Shield of Florida nurses oversee the entire medical record review process.
In an effort to decrease the number of medical record reviews performed in physician offices, the annual Documentation of Care review is conducted in conjunction with the HEDIS study. Within the HEDIS sample, a random sample of records will be selected and reviewed, thereby eliminating the need for another review during the year.
We appreciate your cooperation with this important study. If you have questions, please call the health care management representative, Janet Bailey, R.N., M.S.N., at (800) 262-2166, ext. 59289.