Streamline HEDIS Reporting with McKesson Risk Manager™ Compliance Reporter

Streamlining Quality Reporting

Many healthcare plans are required to use the Healthcare Effectiveness Data and Information Set (HEDIS®) to measure and report quality of care for covered populations. But managing HEDIS reporting is a complicated process — and often a difficult one.

Payers can implement a quality reporting strategy to streamline annual HEDIS quality measurement and reporting activities and to support compliance efforts year-round. For example, a National Committee for Quality Assurance (NCQA)- certified HEDIS quality rules processing engine can simplify the complete HEDIS hybrid review process — from the generation of samples and management of the medical record abstraction process to the creation of NCQA Interactive Data Submission System (IDSS) and Centers for Medicare and Medicaid Services (CMS) patient-level data (PLD) file.

Comprehensive Data Repository for Data Integrity

Online and offline data collection is involved in most medical record review activities. Claims, membership, enrollments and lab and pharmacy data can all be imported into a central data repository, along with scanned charts. This repository can then be updated during HEDIS season with the latest compliance details.

Web-based Workflows Help Streamline Chart Reviews

With web-based medical record review and a centralized, single source of clean data, you can manage the complete process of medical record review for HEDIS reporting. Flexible task assignment workflows allow you to allocate chart reviews manually or systematically by location. Powerful audit tools can generate samples of completed charts for review, as well as measure-level and member-level detail for further research.

Productivity Tracking

A productivity summary for the HEDIS process can help you stay on track by showing status of measures, number of charts remaining and completed by each reviewer, and a summary of members with charts. Tools for external reviewers can generate full compliance and exclusion reports for validation of medical records.

NCQA-Certified Reporting

With an NCQA-certified reporting solution, in-line rate calculation can show the latest results in minutes. Live reports can contain NCQA-certified results for HEDIS measures, and you can generate the required data files for HEDIS and CMS.

Full Suite of NCQA HEDIS Quality Measures

A full suite of NCQA HEDIS quality measures, updated annually, means HEDIS tracking is always ready and up-to-date. Built-in reports help you review the performance of your plan. Graphical displays illustrate compliance, performance detail by product line and by plan, and overall measure performance.

Combine Quality Measures and Risk Management

Pairing Compliance Reporter with McKesson Risk Manager supports the full quality management lifecycle. Together, they provide the robust quality reporting and measurement capabilities you need to be successful, including the calculation of financial rewards for quality and other pay-for-performance (P4P) metrics.