A medical center improves its HEDIS scores

The leaders of Kaiser Permanente San Diego Medical Center didn’t think they were scoring high enough on nine HEDIS measures. Though the center was competitive nationally (above the 90th percentile on six of the measures and within three points of the 90th percentile on three others) it was among the lowest in Southern California.

“Clinical champions” (often specialty department heads) were asked to address the problem, and they set about showing doctors and support staff how to ensure that patients got the care they needed whenever they encountered the health care system. For example, a woman taken to the emergency department might be asked when she last had a mammography.

“In one instance, the clinical laboratory reported that every month, stool samples for colorectal cancer were often discarded because of illegible labeling by patients. A simple fix was to ensure that sample containers were labeled before distribution to patients.”

Performance on selected HEDIS measures improved by 1 to 8.6 percentage points.

HEDIS measure*

*Derived by dividing the number of people who received a service by all of those eligible for it.

Source: “Redesigning Chronic and Preventive Care to Provide a Regional Safety Net,” the Journal on Quality and Patient Safety, November 2013

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HAP, a subsidiary of Henry Ford Health System, is a nonprofit health plan providing coverage to individuals, companies and organizations. This executive develops strategies to meet membership and revenue targets through products, pricing, market segmentation and advertising.  Aligns business among Business Development, Commercial Sales, Medicare and Public Sector Programs and Product Development. Seeks to enhance and be responsible for business development and expansion through the development of an effective product portfolio, strong interpersonal relationships and service excellence.

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