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Greetings from the Quality department at Commonwealth Care Alliance! This quarter we are sharing our appreciation for provider collaboration and exciting news about our future endeavors to support documentation standardization and health record accuracy. 

HEDIS MY 2021 (calendar year 2021) 

Thank you for all your assistance and cooperation during the HEDIS Measurement Year (MY) 2021 season! Working with our contracted providers and seeing the level of care and extent that practitioners go to achieve the highest level of care for our member population is much appreciated.

As we wind down from the last HEDIS season, we find that it seemed more like what we experienced in a pre-COVID world. We take this as a gentle reminder that our systems and workers are resilient and can surmount incredible feats. 

The Quality Programs team at CCA is exploring new and exciting opportunities

Historically, HEDIS has been an annual process owned and maintained by NCQA and completed by health plans nationwide. At CCA, we are initiating a new year-round process to improve documentation for many necessary health maintenance measures. This process will ensure that we have the most accurate and up-to-date information for our members within their legal health records maintained at CCA.

You may hear from our HEDIS team at any time during the year. This opportunity to complete an ongoing review will reduce the burden and volume of one-time requests to provider offices. Another meaningful benefit of this change from retrospective to prospective reviewing will allow us to measure the performance of any given measure closer to real-time. Significant outcomes can be produced from this reporting so that CCA may deploy teams and coordinate with our network providers to outreach to our members for any gaps in care. Real-time information and reporting equip health plans and providers with the tools to ensure that members receive routine health maintenance and follow-up care for their chronic conditions. 

How can you improve your clinical documentation standards throughout your practice? 

The HEDIS manager at CCA has created easy-to-use reference materials to support HEDIS documentation standards. These documents include measure parameters, intent, and guidance for some of the most important and heavily collected HEDIS measures. The Quality Documentation Reference Guides have examples of documentation standards that can easily be applied to any workflow process. 

You can access these Quality Documentation Reference Guides by navigating to the CCA Provider Portal. You can also click the links below: