Written by Richard O’Neill, Search Consultant.
As one of the nation’s best HEDIS staffing agencies, CareNational is always committed to providing the best service possible to our candidates and our clients. This includes continuing education through interactive conversations with contacts from both the client and candidate perspective. As the 2015 H.E.D.I.S. (Healthcare Effectiveness Data and Information Set) season approaches, CareNational is dedicating a series of blogs to help health plans.
The New Year signals the official start of the 2015 HEDIS season, but ample planning is necessary to ensure your HEDIS season starts (and ends) on time. In this blog I would like to review important HEDIS deadlines, what can happen if you get a late start, and how CareNational is here to assist.
According to information from National Committee for Quality Assurance (NCQA), the annual Healthcare Organization Questionnaire (HOQ) opens in the beginning of January this must be completed by Friday, February 27th in order to obtain access to the Interactive Data Submission System (IDSS). At this step your organization must have a primary and secondary administrator for the HOQ and the HEDIS project. You will also need an auditing team to have conduct data validation on a small set of data, and be able to report for this questionnaire. See our prior blog that discusses the HEDIS timeline in detail. If you are just starting to staff your auditors and assign a company administrator for this project then I can tell you why you are behind.
Upon review of the questionnaire and the sample data provided, the National Committee for Quality Assurance (NCQA) will release the IDSS to Health Plans for data loading and validation. Health plans that both hire their staff in advance, and finish the HOQ as quickly as possible, are able to start the full process of actual chart abstraction and later over-reading. Health Plans that do not start staffing their positions ahead of time not only miss out on a larger candidate pool, but also get a late start on some of the most important and labor-intensive aspects of the HEDIS season. Getting a late start on this portion of HEDIS puts you in grave danger of missing very important deadlines that will be fast approaching.
These deadlines start in May when vendors are allowed to start submitting data to the NCQA, and come June 8th your plan must submit its data to allow ample time for review, approve and audit lock the submission. Although this gives you more than 4 months to do the actual abstraction of the data, you must have pre-determined the size and scope of your HEDIS team so that during this time your team can be engaged in abstracting the data. This is why contract HEDIS Project Managers should be identified and hired before the New Year, in fact many organizations keep someone in this role year round. The staff level workers can be hired a little later, but they should be assembled and in the contracting process come January in order to avoid a severely limited talent pool.
CareNational specializes in Quality Improvement and HEDIS staffing / career search consultation in these specialized areas, but we do not perform the functions ourselves. So how did we do? Did you find this information useful? We love feedback!
As always, you can contact one of our representatives at 800-974-4828 to assist you with your HEDIS staffing needs, or if you are interested in finding HEDIS work this year. CareNational provides superior career consulting support, and there is never a fee charged to candidates for any of our services.
Written by Richard O’Neill, Search Consultant. For more information on HEDIS and to discuss our current opportunities, reach out to one of CareNational’s best Medical Management Recruiters!