from the HEDIS® 2017 trenches: optimizing your chases

Posted by Leah Breeggemann on 2/22/17 9:11 AM

The countdown to the HEDIS® 2017 reporting deadline is well underway. Are you on track? Our Verscend experts are here to share their insights on effectively managing your measurement and reporting process in our monthly blog series, “from the HEDIS 2017 trenches.” Here, client manager Leah Breeggemann offers insight on optimizing your chart chasing efforts.

The process of chasing charts reminds me a little bit of my family’s annual road trip, where at the end of every summer before school started, my parents would pack up the family minivan with everything (including the kitchen sink!) and we would go on a road trip. Let’s break down the process into three key tasks you’ll need for success: mapping out your trip (setting up your data for success), optimizing fuel efficiency (selecting effective chase logics), and staying the course (maintaining momentum throughout the chart retrieval season).

mapping the way

You wouldn’t hit the road without a map (or nowadays, your phone) telling you where to go, would you?

Before you send your chase data to your retrieval vendor, it’s critical that you have it in the required format and in good order. With only about 10 weeks to retrieve charts, any small misstep could lead to costly wasted time and effort that will directly impact your scores.

For example, do you want records to be chased for emergency room providers, chiropractors, and radiologists? Will these locations give you the records you need to improve your hybrid measure scores? If not, make sure the chase flag for these providers is turned off.

Another key area to pay attention to is provider location and contact information. As we all know, claims data doesn’t have the best track record when it comes to giving you an accurate location or phone/fax number for a clinic or provider. Pull in provider location and contact info that you compiled last year so that you can be sure you’re giving your retrieval vendor the right information and reduce wasted efforts. Keep in mind that you need to provide the provider’s actual location, not where the claim was billed from.

Make sure your provider contact information is also “normalized” for consistency, looking at the format of street names, abbreviations, suite numbers, and phone and fax numbers, for example. The more consistent this data is, the easier it is to find locations that can be merged together to reduce the number of times your vendor will have to reach out to a particular provider. Similarly, if you’re able to merge any providers who work at the same clinic together on your end, or merge common locations together, your vendor will have fewer phone calls to make to the same office.

optimizing fuel efficiency

If you’re going to refill your gas tank five times on this trip, you don’t want to waste any of it by driving with your tires only half-inflated.

Once you complete your test run, use it to assess how effective your provider and location clean-up efforts have been, then do additional clean-up as necessary. Also be sure to pay attention to your unassigned member count (the number of members who have no chases assigned to them) and apply additional chase logics to lower that rate. Remember: for any members who have no chases assigned to them, you literally have a zero percent chance of making them compliant!

The more effective chases you have, the better chance you have to collect more data, which directly translates into better scores. A chase isn’t an exact science—it’s more like an educated guess, aimed at finding the most logical location where a specific member’s medical record that will have the information you need is stored.

With that in mind, after you complete your test run, it’s time to re-evaluate and re-prioritize your chase logics. Verscend provides our clients a chase priority report to accomplish this goal. If one chase logic yields a lower chase count than another, make it a lower priority. In addition, we can provide a chase effectiveness report, helping you examine last year’s data to determine not only which chase logics were utilized, but which ones actually returned results that made a measure numerator compliant.

staying the course

When you’re flying down the highway at 75 miles an hour, keep your eyes on the road!

Once chart retrieval begins, pay close attention to the number of records coming in and calculate the difference between records expected versus records delivered. Monitor the measure goals that you’ve set—maybe you’ll need to prioritize a certain measure over others for the best results. If certain products have more weight for your organization, prioritizing chases by product could also make the most sense.

In addition, certain provider locations will require a copy service to come on-site in order to retrieve records. Make sure to prioritize these chases, as they’ll require additional time to complete. And be sure to review and enforce any agreements you may have in place with providers regarding record collection. If your contract with the provider says they must provide a record free of charge, don’t pay for them!

Finally, evaluate your internal deadlines as record collection progresses and adjust them, if necessary. If you were planning on ending record collection on May 1, but you could extend that to May 4, this may yield valuable last-minute records that will increase your hybrid measure scores.

Stay tuned in March for our next report “from the trenches.”

Looking for more tips for a successful HEDIS season? Download our checklist to learn additional best practices.

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About the author:

Leah_Breeggemann_Headshot.pngFor the past four HEDIS® seasons, Leah Breeggemann has served as a client manager in Verscend’s Eden Prairie, Minnesota office. Her main responsibilities are assisting our retrieval and abstraction clients in successfully submitting their data to NCQA in order to improve the client’s measure rates by participating in data analysis and quality assurance. A proud “ZAG,” Leah earned degrees in theater and business from Gonzaga University.

 

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

Topics: HEDIS, Quality, Retrieval