Performance measures developed by NCQA and used to evaluate managed care plans are found in the
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Azara Healthcare, a leading provider of population health solutions, announced today that it has received certification from the National Committee for Quality Assurance (NCQA) for HEDIS® Measure Year (MY) 2022 Health Plan and Allowable Adjustments Measures. HEDIS (Healthcare Effectiveness and Data Information Set)
measures, as established by the NCQA, are used to evaluate health plans’ clinical quality and customer service. More than 191 million people are enrolled in plans that report HEDIS results, which includes measures for physicians, Preferred Provider Organizations (PPOs), and other organizations, making it one of healthcare’s most widely used performance improvement tools. Certification validates Azara Healthcare’s quality measures in their calculation of measure performance and care gap
reporting. Certification of these HEDIS measures span the following domains: Azara solutions empower healthcare providers to track HEDIS performance, identify care gaps, and implement intervention models that can proactively improve the health of their population. Together with the newly
certified HEDIS measures, Azara maintains one of the industry’s largest active measure libraries with over 800 discrete quality measures, spanning dozens of practice specialties and programs. “Azara’s health and quality measure solutions continue to enable our clients to track and compare quality performance across their member and patient populations to improve their health and quality of life,” said Jeff Brandes, CEO of Azara Healthcare. “NCQA certification attests that
these measures meet NCQA’s rigorous testing and reporting requirements, saving our clients time and resources that can better be directed to improving the health outcomes of their population as part of performance improvement initiatives, accreditation, and value-based contract requirements. As our clients move deeper into value-based arrangements, the ability for them to track their performance on HEDIS becomes a ‘must have’.” Azara solutions empower more than 1,000 Community Health Centers, physician practices, Primary Care Associations, Health Center Controlled Networks, and clinically integrated networks in 40 states to improve the quality and efficiency of care for more than 25 million Americans. For more information about Azara Healthcare and its population health solutions, visit www.azarahealthcare.com HEDIS® is a
registered trademark of the National Committee for Quality Assurance (NCQA). About NCQA About Azara Healthcare You can use two well-established health plan measurement sets as the basis for collecting data and preparing comparative information for your audience: These
measures have been endorsed by the National Quality Forum, a multistakeholder organization established to standardize health care quality measurement and reporting. Learn about the National Quality Forum. HEDIS refers to a widely used set of performance measures in the managed care industry. More than 90 percent of health
plans—HMOs, POS plans, and PPOs—use HEDIS to measure performance. HEDIS is managed by the National Committee for Quality Assurance (NCQA), a private, non-profit organization that accredits and certifies health care organizations. HEDIS is one component of NCQA's accreditation process, although some plans submit HEDIS data without seeking accreditation. Learn about the
NCQA. HEDIS enables consumers and purchasers to compare health plan performance to other plans and to national or regional benchmarks. Consisting of over 70 measures of process, structure, and outcomes, HEDIS addresses a spectrum of care from prevention to acute to chronic care. It also encompasses health plan members’ assessments of their experiences with
care as measured by the CAHPS Health Plan Survey (described below). NCQA adds, deletes, and revises HEDIS measures annually. HEDIS scores are regarded as highly credible, in part because an NCQA-approved auditing firm must validate results. Also, an NCQA-approved external survey organization must administer the CAHPS survey when it is part of a health plan’s HEDIS submission to NCQA. Data source: You can obtain HEDIS results directly from health plans or by purchasing access to NCQA’s Quality Compass® database of health plan performance results. More details about Quality Compass are provided in Databases Used for Health Plan Quality Measures. For more information about HEDIS or to purchase HEDIS publications, visit NCQA’s Web site at http://www.ncqa.org. CAHPS® Health Plan SurveyCAHPS refers to a family of standardized surveys that can be used to gather and report information on consumers’ experiences with health plans and providers. The surveys are developed and supported by a consortium of researchers with funding from the Agency for Healthcare Research and Quality (AHRQ). The CAHPS Health Plan Survey consists of over 40 items that ask the respondent to rate their experiences with different aspects of care, including access, timeliness, communication, courtesy, and administrative ease. Instruments are available for adults and children in commercial, Medicaid, and Medicare populations. Data source: Some sponsors generate CAHPS data by surveying their own audiences (e.g., employees, beneficiaries); however, sponsors typically get this information directly from the health plans or from NCQA because results from this CAHPS survey are incorporated into HEDIS. For more information about the survey, visit the CAHPS Web site. Also in "Measures of Health Plan Quality"
Which program was implemented so that quality assurance activities are performed?MANAGED HEALTH CARE. Which type of HMO where health care services are provided to subscribers by physicians employed by the HMO?Also called independent practice association (IPA) HMO, contracted health services are delivered to subscribers by physicians who remain in their independence office settings.
Which of the following is an organization that provides health services on a prepaid basis?Health Maintenance Organization (HMO) HMOs offer prepaid, compre- hensive health coverage for both hospital and physician services. An HMO contracts with health care providers, e.g., physicians, hospitals, and other health professionals.
What reimbursement method pays providers pre established payments in advance to provide care to health plan enrollees over a period of time?Also called triple option plan; provides different health benefit plans and extra coverage options through an insurer or third-party administrator. Provider accepts preestablished payments for providing healthcare services to enrollees over a period of time (usually one year).
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