HEDIS measures cover various aspects of health care, including preventive care, chronic disease management, access to care, and patient satisfaction. Health plans use HEDIS scores to measure the effectiveness of health care services and to help identify areas for improvement in quality. Health providers can improve their HEDIS score through innovations such as telehealth and other remote care options. 

HEDIS score definition: 

HEDIS, which stands for Healthcare Effectiveness Data and Information Set, is a set of standardized performance measures used in the health care industry to assess the quality of care and service that health plans and providers deliver to patients. Examples of specific HEDIS measures include rates of childhood immunizations, mammography screening, diabetes management, medication adherence, and follow-up care after hospitalization. Each measure has defined criteria and targets that health care organizations strive to meet or exceed.

HEDIS score measurement:

Upwards of 190 million people are enrolled in health plans that report quality results using HEDIS. HEDIS scores are numerical ratings or percentages that reflect how well a health plan or healthcare provider performs on each of the individual HEDIS measures. These scores are based on data collected from medical records, claims data, and other sources. HEDIS measures the following: 

• Effectiveness of Care.
• Access/Availability of Care.
• Experience of Care.
• Utilization and Risk Adjusted Utilization.
• Health Plan Descriptive Information.
• Measures Reported Using Electronic Clinical Data Systems

In this blog, we will address five remote care options that providers and organizations can use to improve their HEDIS score in these key areas. 

1. Overall Telehealth Optionality 

Telehealth provides patients with greater access to health care services, especially for those in rural or underserved areas. This can lead to higher compliance with preventive care measures, such as immunizations, screenings, and wellness visits, which are tracked by HEDIS. Telehealth can reduce wait times for appointments, ensuring that patients receive timely care. Timely care is essential for HEDIS measures related to access to care and avoiding delays in receiving necessary treatment.

2. Preventative Screening with At-home Diagnostics 

Preventive screenings are an essential component of preventive health care, which aims to prevent or reduce the risk of diseases and promote overall health and well-being. These screenings are typically recommended based on a person's age, gender, medical history, family history, and other risk factors. Some common examples of preventive screenings include:

• Pap smears
• Mammograms
• Colorectal cancer screening
• Skin cancer screening

Patients are more likely to complete these screenings when they can easily connect with health care providers online, leading to improved HEDIS scores in this category. Some screenings, such as those for colorectal cancer, can be completed through at-home diagnostics, wherein the patient submits a sample from home to result in a lab. 

Chat with Ash Wellness about at-home diagnostics for population screening. 

3. Remote Patient Monitoring 

‍Remote patient monitoring is a technology that allows health care providers to monitor and manage patients' health remotely. PM enables continuous monitoring of patients with chronic conditions such as diabetes, hypertension, and heart disease. Healthcare providers can track vital signs, medication adherence, and symptoms in real-time. This leads to better disease management, reducing the risk of complications and hospitalizations.

In particular, remote patient monitoring for high blood pressure helps the nearly half of American adults who suffer from it. Controlling high blood pressure can reduce the risk of heart disease and stroke, two leading causes of death, and improve HEDIS scores. 

4. Medication Compliance with Remote Diagnostics 

Telehealth platforms can be used to remind patients to take their medications, answer questions about their medications, and monitor adherence. This positively impacts HEDIS measures related to medication management. Providers can onboard at-home diagnostics to send test kits home with patients for ongoing bloodwork. Prescription drug use sometimes results in adverse effects that contribute to hospitalization, so ongoing compliance with medication adherence goals improves patient health and safety and reduces care events that could lower HEDIS scores. 

5. Telepsychiatry

Telehealth can improve access to mental health and behavioral health services, leading to better management of mental health conditions. 43.4 million adults in the United States have a mental health disorder, but less than half receive mental health services. Improved mental health care can positively affect HEDIS measures related to depression management and follow-up after hospitalization for mental illness. Telepsychiatry can also utilize at-home diagnostics to help patients comply with medication maintenance testing, such as urinalysis for lithium. 

Conclusion:

Telehealth offers a broad range of opportunities for improving access to care, reducing wait times, and promoting compliance with preventive care measures. At-home diagnostics further empower patients to engage in preventative screenings, contributing to better HEDIS scores in this category. Remote patient monitoring, especially for chronic conditions like hypertension, demonstrates the potential to minimize complications and hospitalizations, ultimately leading to healthier patient outcomes.

In a rapidly evolving health care landscape, the integration of these remote care options not only reflects a commitment to delivering high-quality care but also aligns with the goals of health care providers and organizations to excel in their HEDIS performance. By embracing these innovative approaches, health care professionals can better serve their patients and contribute to the ongoing improvement of health care quality across the nation.

‍