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2020 HEDIS Season is Here!

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The annual Healthcare Effectiveness Data and Information Set (HEDIS®) project is underway! El programa Alliance is working the same HEDIS® vendor as last year, Inovalon. Inovalon will be working with the Alliance to complete medical record retrieval and abstraction.

The HEDIS® medical record retrieval and data abstraction project will begin early February and proceed through early May. The following HEDIS® measures will be reviewed this year; Childhood Immunization Status, Well-Child Visits in the First 15 Months of Life (New), Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life, Immunizations for Adolescents, Cervical Cancer Screening, Prenatal and Postnatal Care, Controlling High Blood Pressure, Comprehensive Diabetes Care, Weight Assessment and Counseling: BMI Assessment, Adolescent Well-Care Visit (New), and Adult Body Mass Index.

Important reasons why you should provide information for HEDIS:

  1. The California Department of Health Care Services (DHCS) requires health plans to collect and report this data annually. As health care providers and administrators, HEDIS® helps to evaluate the health of our members in the communities that we serve. We use this data to monitor:
    • Quality of care delivered;
    • Rate at which members access preventive services;
    • Indicators that describe how well members are managing chronic conditions;
    • Provider performance; and to
    • Monitor Overall plan performance
  2. The Alliance uses HEDIS®data to develop and enhance educational programs, member benefits, and provider
  3. As a network provider, you have agreed to participate and cooperate with our quality and audit programs, including providing medical records where

We thank you and your staff for partnering with the Alliance to improve the health of our members.

If you have further questions, please call the Britta Vigurs, Quality Improvement Projects Specialist at (831) 430-2620.