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Takeaways from the 2018 HEDIS medical record review

Brian: 

 

[inaudible 00:00:49] There are two offerings for this webinar, today and tomorrow, June 21st, at 2PM eastern standard time. Prior to the webinar today, you should have received the slides via email from me. I just ask that you please follow along with us today. My name is Brian Clark and I'm your host. My title is quality translator, and I work in quality management here at Aetna better health, and also presenting today is Diana Charleston, quality management nurse consultant, and Debby Barkley, quality management nurse associate. All three of us work in quality management here at Aetna Better health. 

 

Brian: 

 

I'd like to welcome Illinois, Maryland, New Jersey, Ohio, Pennsylvania, Texas, Louisiana, Kentucky, Florida, and Michigan to the webinar today. Very happy you could fit this important webinar in your schedule today, and also a special welcome to provider [inaudible 00:01:55] from the state of Virginia. Very happy to have you join us as well today for the first time. We have a big group with us today, and a lot of people have signed in. We had a big registration list, and it looks like a decent amount of those registrants are actually with us today, so welcome. 

 

Brian: 

 

Today's webinar will last approximately 30 to 40 minutes, and then we'll have some time for questions at the end. During the presentation, we will be posing polling questions to the audience as well. 

 

Brian: 

 

Aetna's vision statement or philosophy as to the way we manage healthcare is you don't join us. We join you. By joining you all on the line today in this webinar environment, it's our hope that we're more effectively reaching our Aetna better health membership. On the screen here you see the Aetna values wheel. At the center of all that we do here at Aetna are the people that we serve, meaning you, our providers that are on the line with us today, and our members. Surrounding the center of the values wheel are our four core values, integrity, excellence, inspiration, and caring. 

 

Brian: 

 

The goal of this webinar today and in all webinar in the series is to start conversations with providers in multiple states nationwide while attempting to explore ways to cut down on the burden of medical record review and maximize administrative data capture. Now, the target goals of this specific webinar today, we would like to discuss the provider experience with the 2018 [inaudible 00:03:37] medical record review season, which occurred between February and concluded sometime in may. We'll also look at lessons learned and takeaways of the health plan. Finally, we'll address tips and recommendations both from provider and the health plan for future success of this project. 

 

Brian: 

 

Like I said earlier, we'll be pausing for Q&A. Let's just go over how to use the Q&A box. First of all, participation is encouraged. I'd like you to use the Q&A box whenever I ask you to, respond to polling questions whenever prompted to. A little popup will come up on your screen and all you'll have to do is click one of the options. The we'll look at the poll results. To utilize the Q&A box, if at any point you need to say something to the panelist during the webinar, hover your mouse over the top part of the middle of your screen, and find the option for Q&A, and then choose the participate dropdown option and type your question or comment in that little white box and send to all panelists, okay? 

 

Brian: 

 

A little bit more about today's agenda topics. We went over some of the goals of the webinar, but here are just some highlighted agenda topics. First off, we'll look at the provider experience with the review this year. We'll take some questions from the audience in the Q&A box and also pose questions via polling. Then we'll look at remote access and onsite review, and look at the difference between administrative data verus medical record review, just to name a few topics that we'll be going over today. 

 

Brian: 

 

As a refresher, for those that are unfamiliar with HEDIS, we'll go over what that stands for, but here's a refresher who those do know what HEDIS stands for. HEDIS stands for Healthcare, Effectiveness, Data and information Set. HEDIS was developed and is maintained by the national committee for quality assurance, or the NCQA. It's a standardized way for health plans to document healthcare services provided to members. Now some states may offer certain pay for quality programs based upon achieved HEDIS rates such as value based services contracting or quality incentive programs. Now currently, we are in the measurement year of 2018. Now, HEDIS 2019 is the season that we're looking at, which looks at data for care primarily in 2018. HEDIS data is collected two ways, claim or other administrative data, and medical record review or data collection. Claims are the fastest and easiest way to collect HEDIS data, but direct coding is extremely important. 

 

Brian: 

 

I just want to mention that throughout the webinar series, we've been going over some recommended HEDIS codes to capture care more effectively administratively. For a full complete listing of codes, you can go to NCQA.org and you can request a copy of the HEDIS technical specifications for 2018. 

 

Brian: 

 

Who uses HEDIS data? The public might use HEDIS ratings when choosing a health plan. Regulatory bodies might use HEDIS data for accreditation and enrollment purposes, and very often pay for quality programs, if there is one offered in your state, are often tied to HEDIS scores. 

 

Brian: 

 

That's enough from me for right now. I want to pause for questions or comments that are coming into the Q&A box. Madison [Yonliski 00:07:35] is going to be handling the Q&A box, and she is a quality translator also working alongside Deb and Diana and I at Aetna better health quality management team. Madison, do we have anything going on that we need to address in the Q&A box? 

 

Madison: 

 

Hi Brian. We don't have any questions at this time, but I do like to clarify that if we do get any questions that we're not able to answer or we're not able to get to your question if we have a lot of questions during this webinar that we do follow up with you with an answer after the webinar. 

 

Brian: 

 

Yeah. I also want to add that if a question is too state-specific for the panelists to answer and we need to go out to the state for an accurate answer to your question, we'll have to wait until after the webinar as well to respond to that state-specific question. 

 

Brian: 

 

Anyway, from here, why don't I pass the ball off to Deb? Deb will take the ball from here. First, we're going to talk about some HEDIS terms and then move on into the medical record review season in review. 

 

Deb: 

 

Thanks Brian. Yes, let's just jump right into these HEDIS terms real quickly. First off, we see the term denominator. That, plain and simple, is the total number of members that fall into a measure. Numerator is the count of adherent members. When you divide the numerator by the denominator, that gives you the rate or the percentage of members that are adherent to the measure. For the most part, the higher the rate, the more members that are adherent to the measure, and the exception to that is an inverse measure where the opposite is true. 

 

Deb: 

 

Next term we see is the word hit, and that's when the administrative data and/or the medical record meets all of the HEDIS requirements for that measure. Next slide please. Administrative data. That's HEDIS information that's captured by any other means other than the medical record. That's by claims, immunization database, and historical encounters. Some of that may come from databases from the state. Some may come from how information could be collected from a free event. All of that can be somehow captured as administrative data. Hybrid review, when the medical record review is used to satisfy HEDIS measurements that are not captured administratively. Next slide, let's move on. 

 

Deb: 

 

Now, we are going to get into the interactive part of the presentation. We're going to share some our findings from the 2018 HEDIS season and give you the opportunity to share some of your experience, your observation, some suggestions that you might have. The way we'll do that is through polling questions and some free text comments that you can type in. We want 100% participation. The more responses we get, the better picture of the provider experience we get. We also know we've got quite a large audience as Brian said. We've got quite a few people who are internal and some that are from the outside. We are going to reserve this opportunity to answer just for our provider attendees. Are you are with that, we're going to ask that you just hold your responses and don't respond to the polling questions. Thanks so much. 

 

Deb: 

 

Let's talk about administrative data versus MRR. Over the years, we have seen an increase in the amount of administrative data that's being captured, and that's a very good thing. More organizations are using NCQA accepted coding. That's a very good thing. That's allowing us to capture a lot more information. Another method that a lot of information is being captured is by data sharing. There are a lot of options there, some third party organizations or something to set up directly with the plan of how data sharing can happen. We noticed a great increase in that. 

 

Deb: 

 

We know that also MRR will probably never go away to a certain extent, and we'll always have to do that to a certain extent. There are certain measures required by NCQA that have to be captured through medical record review. But, we know that medical record review for the most part for information that can be captured administratively is not very cost effective. Just want to let you know, we've gathered information from across ten plans. Along with the hours and the man power that you spend with the HEDIS season, we'd like you to take a guess as far as how as how many hours the health plan has spent with capturing HEDIS data. You can type your answer into the Q&A box, and we'll just see what kind of responses if you'd like to just type a number, number of hours you think across 10 plans Aetna has spent, Aetna Medicaid has spent capturing data. 

 

Deb: 

 

Madison, are we getting any responses? 

 

Madison: 

 

Hi Deb. We have some responses coming in. Somebody said 500. Somebody said 2,000. Somebody said 50,000. 

 

Deb: 

 

I see that million response, too, Madison. 

 

Madison: 

 

It feels like it. 

 

Deb: 

 

[crosstalk 00:13:33] we have felt like a million hours. It was about 50 hours across 10 plans, so as you can see, there was a lot of effort put into this. It's worthwhile because it gives us a chance to get a picture of what's going on with the members and the health care that they're receiving. Next slide. 

 

Deb: 

 

Here's an opportunity for you to type in a response into the Q&A box again. What do you think are the benefits of reducing the total hours required to complete HEDIS MRR projects? The whole goal of this is to see how we can get it done better next year. What do you think is a benefit to you as a provider are to reducing these hours? 

 

Madison: 

 

We did get somebody who responded already. They said, "Save money." 

 

Deb: 

 

Save money. 

 

Madison: 

 

More time with members and patients. Cutting back on paperwork. Productivity. A lot of people are saying that it would allow them to have more time with their patients that they see in the office. 

 

Deb: 

 

You know what, and we agree totally with that. Let's move onto the next slide. Along with those great answers that you've given, we have given a couple of our thoughts. As you can see, one of those, there's more time to spend with the patients. Absolutely, and there's more time to spend on outreach. That's a great advantage because there are many organizations that have a really robust outreach program, and they use it in an effort to increase those outcomes and reduce risk. Also, we've got listed there that there's less time required just processing fax requests and so forth. It's all of our goal to streamline this process. Next slide please. 

 

Deb: 

 

Here are some thoughts of how we can get there. One thing we'd like to offer to you, and Brian said he's going to give you the name of your point of contact at the end, you can work with your point of contact throughout the entire year to help close HEDIS gaps and see how you can send that information through claims, and it can be captured administratively. Just to let you know, through this webinar series, we give you a lot of those coding tips to help with that process. A resource that's always available to you for purchase is the HEDIS tech specks, and that you can get from the NCQA website. You can make sure that you're coding appropriate to close those gaps throughout the measurement year. Next slide please. 

 

Deb: 

 

We're going to start the polling questions. Like I said, we'd love to get 100% participation, so if you would prepare and get ready to answer the questions, here we go. First question, very plain and simple. We just want to survey who's in the audience today. What type of office are you calling from? Are you from the OBGYN, primary care, pediatric, are you calling from a lab, behavior health or some other? If your answer is other, you can type into the Q&A box where you're calling from. If you would go ahead and click on the answer with the polling question, well give you a second to answer here. We like to see a cross section. Brian, whenever you decide to get those results, that's fine. I'm just going to probably talk some. 

 

Brian: 

 

Yeah, Deb. Let's just give it about another 45 seconds or so. We still have responses that are coming in. 

 

Deb: 

 

Great, great. We really appreciate your response. Like I said before, it gives us a good picture of the provider experience. Oh, see, someone here is from the specialty pharmacy. Thank you so much for joining us. As we are getting more answers, we know that a lot of the care is done in the primary care office, whether that's pediatric or family practice or some other type, but there is some care that NCQA will accept from other provider types. We are glad to see a cross section of attendees. Also, some information is collected through pharmacy data, so it's good for those that work with a pharmacy that you can get some of that information, too, and see how it works and what we're looking at. Also, we do select information from laboratories. We just love having a cross section. 

 

Deb: 

 

Taking a look here, we've got a good part of the audience responded. We're very pleased about that. I am missing those percentiles on the right. It looks like most of our attendees are from some other type of organization other than primary care or pediatrics. We've got a good cross section from primary care and pediatrics, and a few from labs, and a few from OBGYN. Thanks so much everyone. We're going to move to the next question here. 

 

Deb: 

 

Very simple, just to add onto that, if we could get your title, whether it's office manager, medical records coordinator, physician, nurse, billing specialist, or other. Once again, if it's other, please type what your title is into the Q&A box. We have found in the past that it's very helpful for cross sections, once again, of job types to be in attendance. We have had quite a few physicians join us. Also, if in your organization there are providers where there are doctors, nurse practitioners, PAs that are interested in attending, we have had providers that find it helpful, and we've had physicians that attend more than once to some of our webinars. In addition to that, billing specialists find it extremely helpful. 

 

Deb: 

 

Let's see what kind of responses we got. Poll has ended. We've got what kind of responses here? 

 

Brian: 

 

Deb, we should have the responses showing up on the screen here shortly. 

 

Deb: 

 

Okay, great. For some reason they're a little delayed. We've captured that information. Oh, here we go. Okay. We've got a lot of billing specialists and once again, other. We've got some office managers, almost an even split. Just a little bit more of the billing specialists than others. We've got a physician and some medical record coordinators. Thanks so much. We're going to move on. 

 

Deb: 

 

Let's get to our next question. Did the 2018 HEDIS medical record review change your daily office activity? This is pretty easy to answer. Yes, no, or somewhat. If you'd like to add any additional comments, you can also type that into the Q&A box if you like. We'll capture that information, kind of get your thoughts on that. We should be able to answer this fairly quickly. I think we're getting, if we could possibly increase those responses, it would be awesome. 

 

Brian: 

 

Deb, responses are still coming in, so let's give it another 30 to 45 seconds, okay? 

 

Deb: 

 

Sure will. During the HEDIS season, there are various methods of collecting the methods. It's done through fax, a [inaudible 00:23:03] review. Some remote access, and other methods. For the most part, most offices do fax in the records. We've definitely seen an uptick in a use of third party copying services and we can see how that is advantageous to some of the offices and why they might use those. There are advantages and disadvantages to all methods. We'll talk about that a little bit more. 

 

Deb: 

 

I think, Brian, we've ended the poll and we should be seeing those responses shortly. We found out that the majority found it ... That was a little bit of, or somewhat of a change in the routine of the office. Almost an equal amount said that there was no change. For some, they definitely felt a change in their routine with the HEDIS medical record review. Thanks for those responses. Let's move on. 

 

Deb: 

 

Who was responsible for coordinating medical record transmission, sending those records to the health plans? We do recognize that Aetna better health, or Aetna Medicaid was not the only company or payer that you were dealing with, so how did you handle that? Who was responsible? Was it a third party copy service? Does your organization use a centralized medical record contact, especially from very large organizations? There is a medical record coordinator that all this is handled through. Also, some offices, they have found it efficient to do it right there in the office and use their office staff. How do you guys handle it in your organization? Who was responsible for coordinating those medical record transmissions to the payers? 

 

Brian: 

 

Deb, we're already getting a pretty good response for C, I can tell you that right out of the bat, but let's wait for the poll to slow down here, the responses to slow down. 

 

Deb: 

 

Right. Thank you so much Brian. Just as, I'm anxious to see that response. I know when using 3rd party copying services, we are contracted with the provider directly, and the provider is contracted with the services. Just as an FYI, we always send the request to the provider office. If for some reason the third party copy service is delayed in sending the records, we will always reach out back to the provider office because they are the organization that we have the relationship with. We're taking a look here, and by and large, the provider office staff takes care of transmitting those records. We see that as far as those that responded today, there are fewer using third party copy service and a moderate amount of those that responded have a centralized medical record contact. Thank you so much for that information. Let's move on to the next slide. 

 

Deb: 

 

Which was the most effective way to transmit records to us? Was it faxing, secure email, the portal upload? I know many parts of Aetna Medicaid have a secure provider portal that you can upload those records to. An onsite review where someone comes out from the health plan and they have access to your records, remote access whether you have given electronic access to your records that someone can, from the health plan, access your records remotely, or a third party copy service. Which do you find the most effective way? I know here in Pennsylvania we definitely saw an uptick in the use of the provider portal. We found more and more organizations asking if they could upload the records through the portal. Faxing, definitely our mainstay of how we got the records in. We actually reduced some of our onsite that we did in the previous year in our state. Remote access definitely increased. We did see a little bit of an uptick in some third party copying services. Let's find out what your experience was. 

 

Deb: 

 

What was the most effective way for you guys or your organization to submit records to us? 

 

Brian: 

 

Deb, responses are still coming in. Let's give it a little bit more time here. 

 

Deb: 

 

Okay. I didn't mention about secure email. Just to let you know, we do have encrypted or secure email that that's available. I know that's a two sided thing whatever your internet security allows or your security system with your organization. We have used that also. Let's see. The poll is closed, so let's see what kind of responses we got here. 

 

Deb: 

 

By and large, faxing. From those that responded, by and large, faxing was used. Some secure email. Almost the same amount of portal uploads. Onsite review just came in a little bit under that, and a few remote access. I think that's the last part of these polling questions. There's a few more questions that Diana is going to ask you, and you'll be able to type those answers into the Q&A box. I want to thank you for taking the time to answer these questions. We definitely are looking to make the provider experience and the whole HEDIS medical record experience more efficient in the years to come. Diana, I'm going to pass it off to you now. 

 

Diana: 

 

Thank you very much Deb. My name's Diana Charleston. I'm one of the registered nurses in the Pennsylvania plan quality department. My first slide here is a question. It's a general, what types of barriers do you as providers experience when you're trying to address the following HEDIS measures categories during visits. For the condition-specific measures, for example, diabetes, are you finding that things happen, you're prescribing labs and members aren't going to get their A1Cs done, they're not getting their eye exams completed? Those pediatric categories, those well care measures, are you finding that a lot of members aren't scheduling well care visits? They're only coming in for sick visits. Same with the women's health screens. Are they just not getting those tests done maybe? If you could please type your answer in the Q&A box and send to all panelists, we're looking to see what types of ways we can work with the office to overcome these barriers for the future. Partnering with more member outreach, scheduling health screening events to try to close some of these gaps. 

 

Madison: 

 

We haven't gotten any responses in yet, so maybe give it another moment to let people type their answers. 

 

Diana: 

 

Sure. We definitely want to work with the providers to overcome the barriers during the actual measurement year so that maybe we can decrease the need to request medical records, getting those members in and then coding for the care that's referring. 

 

Madison: 

 

We do have some answers that came in now. Somebody said getting patients into the office for follow up tests, like A1Cs, well care visits. Somebody said BMI measured, not meeting ICD [inaudible 00:32:08] guidelines for pediatric. Let's see here. Pediatric no-shows. Just not showing up for their appointment. A lot of responses for pediatric offices. Another person said no-shows. We're getting a lot of really good responses in now. 

 

Diana: 

 

Great. This is wonderful that we're getting those responses. It's going to help us gather more information, and we as the health plan can work with these offices that are having problems with members getting in, maybe work to do reminder calls or just help them get the members scheduled for appointments. I guess, Brian, we can go onto the next slide. 

 

Diana: 

 

The next two slides for me aren't any questions as of right now. More, just some recommendations for future success from the plan's perspective, ways to improve HEDIS metrics and data capture with regard to coding. It's always good to use accepted NCQA HEDIS CPT, CPT II [inaudible 00:33:15] and ICD-10 codes to ensure that all care is captured administratively. We want to gather a record of care from charts and submit appropriate NCQA accepted HEDIS codes. We're trying to limit the need to burden the offices with requests for medical records. To get the full listing of codes, you need to go the NCQA website at NCQA.org and click on publications and products and order the HEDIS 2018 technical specifications for physician measurement. 

 

Diana: 

 

Another way to capture data is administratively, and we want you to reach out to your state appointed contact for the best process on how to do this. Data sharing, that's another method that can close gaps administratively without the need to resubmit claims. 

 

Diana: 

 

Another takeaway that we would have would be remote access benefits. Looking to see, with regards to remote access, we're guaranteed that the correct records will be pulled for gap and care closure. We have a trained HEDIS expert from the plan going into the EHR pulling the records. It's going to limit the need for follow up and requests due to missing components of the record. Remote access is also scheduled ahead of time so as not to disrupt the offices. The biggest plus to using remote access is that the staff does not have to pull the records. The office staff can focus on patient care. 

 

Madison: 

 

Diana not to- 

 

Deb: 

 

[crosstalk 00:34:44] 

 

Madison: 

 

Go ahead. 

 

Deb: 

 

Sorry, Madison. We were going to say the same thing. 

 

Madison: 

 

Most likely. 

 

Deb: 

 

We have a folks that are having a hard time hearing you. You may be sounding a little distant. If you would be able to speak up or perhaps switch to handset, that may be helpful. 

 

Diana: 

 

Sure. Let me take one second to switch to my handset. Right now I am on my headset, and I apologize that people are having difficulty hearing me. One second. Is this better? 

 

Madison: 

 

Much. 

 

Diana: 

 

Wonderful. I do apologize, everybody, for the difficulties before. Would you like me to repeat the slide, Brian, or should we proceed on? 

 

Brian: 

 

You know, Diana, I think it's safe to proceed on from here. You sound loud and clear. 

 

Diana: 

 

Okay. All right, we can go onto the next slide. 

 

Diana: 

 

Some more takeaways and tips and recommendations for success with HEDIS would be regarding lab results. Ideally lab results should be coded appropriately so as to cut down on record requests. Always code for the lab results if you're performing the lab in house. We're finding a lot of times we capture the testing, but we're not capturing the result. Aetna better health does have lab vendors, which would be Quest and LabCorps, so if you're sending members to those labs, we get those results administratively. If you're doing the labs in house, we would want you to try to code using those NCQA coding tips for lab results such as an A1C. 

 

Diana: 

 

The last component that we have here with regards to when we do have to go to the medical record, if we're not capturing care administratively would be the complete documentation and chart. It's always good to document, document, document. If it was discussed, addressed, or mentioned, make sure to note that in the member chart. This would include refusal to services in the chart, which could be immunizations, or also refusing tests such as a PAP. Next slide. 

 

Diana: 

 

Those were just some tips and recommendations from the plan's perspective on how to improve the HEDIS process for the future. What are some suggestions from you as a provider as to how the medical record review season's overall process could improve? How can we make it easier on you at the office? If you could, please type your answer in the Q&A box and send to all panelists. 

 

Brian: 

 

Hey Diana, I think this is a very important question, so let's make sure to address each individual response that comes into the Q&A box. Let's pause and let everyone type in their responses. 

 

Diana: 

 

Sure thing. Just so you know, if we don't get to answer your question today, we do capture your email with your name in the chat box. We'll have your point of contact follow up with you after the webinar if we cannot address your questions today. That follow up will occur within 24 hours. 

 

Madison: 

 

We are getting some responses in, so I'll start to read through these as they're coming in. Somebody [inaudible 00:38:06] we tell them exactly what we need so there's less back and forth via faxes and phone calls. Somebody said that they like our site visits. It does not take that much of their time. Quicker capture of measures via claim submission, remote access. Sorry I lost my spot there. Remote access quarterly with incentives. Reminder calls for teams. We are happy with using remote access and email correspondence to request it. Somebody said increasing remote access so that HEDIS reviewers can have the full access to medical records remotely. A lot of responses about remote access so far. 

 

Madison: 

 

Cut down on multiple requests and voicemails, please consolidate the request for all the providers in the group. Do not call multiple times. Cutting back on our requests to them and not sending multiple phone calls and faxes. AETNA is becoming ... Oh. Let me see here. I keep losing my spot here. We're getting a lot of answers in, which is great. Provide advanced notice of exactly what's being requested, so that's kind of going back to telling them exactly what we want. We have a couple of responses for on site visits. Lots of really, really good responses coming in. 

 

Brian: 

 

Diana, are you on mute? 

 

Diana: 

 

I went on mute, and I apologize. I just started talking. One thing I did want to add before we proceed on is regarding telling the providers exactly what's needed from the get go. We do have a reference guide that does go out with our facts blast that goes over the measures. We're going to be looking at that in the next two slides. It'd be really good, once we review that, to get some more feedback on what can we do to improve this guide. Brian, I guess at this point, we can proceed on. Again, if any questions aren't answered right now during the webinar, your point of contact will be following up with you within 24 hours. 

 

Diana: 

 

As I previously said, we have the HEDIS chart guidelines document. Again, this went out with the facts blast from the plan to the providers. You can see, we do list the measure keys, the measure description, and the definition of the measure, and also the service dates that are being requested. We do try to simplify this for the provider's offices so that we can just easily identify what is needed to close that gap. Looking at adolescent well care for example, in bold print, we are asking for all office notes during the measurement year, which for this HEDIS season we just completed, was 2017. This would include sick visits. That may include the following: health history, physical exams, mental and physical developmental history, and anticipatory guidance. 

 

Diana: 

 

Just using that as an example, how could we make this a little more easier telling the providers when we send that facts what is needed? You can see each of the measures on the screen there is a breakdown on what is needed per measure. Brian, let's go to the next slide. 

 

Diana: 

 

This is the second half of that HEDIS chart guideline document that went out with he facts blast. Looking again, we have well child visits, but then we also have some prenatal measures on here. We're looking for prenatal care and office notes, and we list the various items that we need with regards to the prenatal post-partum care and the frequency of ongoing prenatal care measures. Would there be a better way for us to simplify these for example? Or any of the measures listed on the screen? 

 

Diana: 

 

Regarding the HEDIS chart guidelines document, how can we make this document more user friendly for you at the office? We'd ask to please type your answer into the Q&A box and send to all panelists. 

 

Madison: 

 

I'm just giving it a moment, Diana, for people to type their responses. 

 

Brian: 

 

Hey Diana, I want to address one comment that's in the Q&A box right now. It appears that an attendee would like all of the fax requests, the individual fax requests, it seems like they're going out to multiple offices. It appears that this one person would like all of the requests to go to her. That's an important thing to know. Rosario, at the end of the presentation, I'm going to be linking everyone up to a point of contact in each state. If you are the person that needs to get the request for your entire organization if you have multiple sites and you have a centralized DHR system, and you want all the requests to go to you, we need to know that so we're not sending out multiple requests to all the offices and disrupting the flow. I just wanted to bring that up that if you are the centralized contact for medical record review, if all requests need to go to you, it's important that you work with your point of contact to let them know that that's how you want it to go next year. 

 

Brian: 

 

A little bit off topic from the current question, but I thought that we needed to address that particular comment that was in the Q&A box. 

 

Diana: 

 

I definitely agree. If there's a centralized person, we want to be working with that person and not tie up phone lines and fax lines at the offices that are trying to take care of the patients. 

 

Madison: 

 

We did get a couple of responses to the question that was asked. Somebody said, "If we could put on there how it could be captured and claimed. Maybe some coding tips on the sheet as well. Somebody said they like the one that we have and they think it's great. No suggestions there on how we can change that. Let's see here. Somebody said for the HEDIS measures, like an A1C or LDL measures, should they be referring to the latest lab report or is there a timeframe? Typically those are things that are specified on the guidelines. We try to make sure that we put it as clear as we can on there what the guidelines are for those specific measures. 

 

Diana: 

 

I'm looking right now at the CDC one for example, and it does not specifically say for the lab results. For the A1C specifically, we do look for the last screening in the measurement year, so that is something that we would definitely want to make sure is noted on the guidelines in the future. I see the last BP was listed, but not for the A1C. That is a very good takeaway for us to have at the health plan. 

 

Madison: 

 

I'm not seeing any other responses come in at this time. I think it's safe to move on. 

 

Diana: 

 

Sure thing. Thank you. At this point, I'm going to pass the ball over to Brian. Thank you, everyone, for listening today. 

 

Brian: 

 

Thanks Diana, and Deb, thank you as well. Now is the portion of the webinar where I am going to link everyone up to their point of contact by state. That is a rep the health plan can inform you as to how to access your organization or your office's gaps and care reports throughout the measurement year so you can be actively, proactively outreaching members and getting them in and closing gaps throughout the measurement year, and coding appropriately so we don't have to reach out for as many records from medical record review. Just to let you know, some measures do require medical record review, but, if throughout the measurement year we can address those measures that can be captured administratively, let's go ahead and do that. The point of contact in your state can work with you to accomplish closings gaps in care. Also, if you're the point of contact at your organization that needs to receive the medical record review request for records, we need to know that. Work with your point of contact to set that up for next year. 

 

Brian: 

 

If you just have a question or a comment or an issue, that's the person, this email contact that I'm going to introduce you here to shortly is your first person that you want to go to, and then if they can't answer the question or comment, we'll make sure that the appropriate person within Etna's organization gets to the bottom of your question or comment. In Florida, your contact is Michelle. In Texas, you want to reach out to Joanna. Virginia, that's going to be Jennifer. I'll just pause for a second if someone wants to take a screenshot of this particular slide. Also, you really didn't need to worry about taking too many notes if you wanted to take some notes about the audio. That was fine. I have a copy of these slides, and they were sent out prior to the webinar, but if you weren't able to receive the slides via email from me, please type into the Q&A box how you'd like me to get the slides to you, via email, or I can fax over the slides or something like that. 

 

Brian: 

 

Let's move on. Pennsylvania, your point of contact is Diana. She was a speaker today. Louisiana, that's Frank. Michigan, you want to reach out to Dante. Illinois, you can reach out to Anya or Diana. Maryland reach out to Don. New Jersey, Sami. Ohio, you want to reach out to either Sarah or Valerie or both. Kentucky, your go to point of contact is Kathy. Let's just look at future webinars here. The next couple months, the first webinar coming up here soon is back to school physicals and HEDIS measures affecting 0 to 11 year old measures, and the EPSDT. We'll look at how HEDIS is addressed in the office as well as how it's appropriate coded for when it comes to this population of members and the measures that can be addressed for a 0 to 11 year old. 

 

Brian: 

 

August, we'll look at the teenage years, back to school physicals for 12 to 21 year old members, and then September, we'll look at 21 and older members and the HEDIS measures addressing that population. 

 

Brian: 

 

If you have any questions or comments right now, please type into the Q&A box and we'll try to address anything that is not state specific. If something is state specific, your point of contact will be in touch with you within a response within 24 to 48 hours. I want to thank everyone for being with us today, and look forward to having you back in the future. I hope today's webinar was beneficial for you and you found it to be worth your time, and I hope that we have a good medical record review season next year, and that we capture a lot of care administratively via claims throughout this measurement year. Thanks everyone and have a good day. 

 

Brian: 

 

Madison, did we have anything in the Q&A blocks for those that are still going to stick around for a little bit? I want to make sure that we address any questions. Actually, let me take a look at the Q&A box. I'll just look at this here. 

 

Madison: 

 

Okay. Yeah, we do have a couple of questions that came in. I'm not sure if you want to address them out loud or just address them individually. 

 

Brian: 

 

I'll address a few of them out loud. For those that need a copy of the slides, I'll make sure to send the slides over to you after the webinar today. Rosario, the information for Sammy Whitty is within the webinar slides. Did you get a copy of the webinar slides? If not, I'll make sure to send a copy of the slides to you. Alyra, you can definitely get a copy of your panel list from your point of contact. Please reach out to your point of contact via email. 

 

Madison: 

 

Brian, somebody asked about the recording for the webinar. I don't know if you want to maybe touch base on that real quick. 

 

Brian: 

 

I keep track of all attendees that have attended webinars in the past, and what's going to happen very soon is there's going to be a link that I'm going to send out via email to all past attendees that you can click on. We're actually building a website to house all previously recorded webinars going back to January of this year. I just want to let you know that soon you'll be receiving an email. Actually, the website is almost done being built that houses the webinar recording. More to come regarding access to previously recorded webinars hopefully soon. I know that we have January through March already up on the website that's being built, and we're going to be working on April through June and getting those up soon. We're recording and we are going to have a link for you to access here, soon. That link is also going to be on the Aetna better health portal, the website in your state, and your point of contact will be reaching out to you to let you know where you can find that link on the website also. 

 

Brian: 

 

Okay, so someone is requesting Maryland's point of contact. That's Don Miller, Donald Miller and [inaudible 00:54:14], did you get a copy of the slides? The slides indicate how to reach out to that point of contact via email. If you didn't, I'll make sure to get a copy out to you. I see that North Carolina, we have provider attendees that are signing in from North Carolina and Tennessee. However, the plans that are included in this webinar series, we actually do not have those states on board with the webinar series. Now, do you have providers in the states mentioned in either Illinois, Maryland, New Jersey, Ohio, Pennsylvania, Texas, Louisiana, Kentucky, Florida, Michigan, or Virginia? If so, we need to know where your providers are, and then we'll make sure to get the point of contact for those states over to you. Currently, we don't have a point of contact for those two states. 

 

Deb: 

 

Brian, in the meantime, they could certainly use one of us in Pennsylvania, right? To communicate with and be sure that any questions get answered? Should that be you or Diana? Or who should they ... 

 

Brian: 

 

Yeah. For right now let's go with Diana. 

 

Diana: 

 

Okay. 

 

Brian: 

 

It appears that the questions are slowing down here in the comments. I'll let everyone go. Have a good day, and we'll see you in the next webinar. Tomorrow's offering is a repeat offering of today's webinar, and it starts at 2:00 eastern. If anyone within your organization wasn't able to attend today and you feel it would be beneficial for them to attend the repeat tomorrow, make sure that you pass along the invite that you got to your interested colleagues within your organization so they can register for tomorrow's webinar. Thanks everyone. Have a good day. 

 

 

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