HEDIS: Crossing the Finish Line

By Melanie Richey

Wrapping up HEDIS® 2016 with an eye towards HEDIS 2017

You’re in the home stretch and can see the finish line in the distance.  It’s almost time to celebrate the close of another HEDIS project. There are just a few more items to check off of your project plan now that you’ve finished the preliminary rate review with your auditor.

First Things First

The next few weeks will be very hectic, as your team completes medical record data abstraction and submits numerator-compliant counts for Medical Record Review Validation (MRRV) to meet the May 16th timeline.  Once your auditor selects the measures for the MRRV review, you’ll need to gather the medical record documentation and send this to the auditor no later than May 27th.



Your auditor will begin providing feedback about the MRRV results and any associated corrective action plans by June 1st.  Remember, there’s a quick turn-around time to address corrective action plans in order to submit plan-locked submissions by the June 8th timeline.


Final Rate Review

Finally, your auditor performs the final rate review, ensuring the MRR numerator counts from the IDSS and the list submitted to the auditor May 16th match.  Once this is verified, you can submit the auditor-locked IDSS and attestation and/or the Patient-level data for Medicare products on June 15th.



Now you can breathe a little easier and enjoy some down time away from the hectic pace that your team has maintained in order to successfully complete your HEDIS project.  After all, the 2017 HEDIS Technical Specifications won’t be available until July 1st.


As you know, there is very little down time with HEDIS.  The brief time between hitting the submit button and focusing on the next HEDIS season seems to get shorter every year.

We suggest that you implement the following activities to keep your 2017 HEDIS program on track for success.


HEDIS 2017 Strategy

Proactive outreach to members and providers to close care gaps by the end of 2016
Year-round medical record data abstraction for the 40+ measures eligible for supplemental data numerator compliance
Leverage member and provider communications to increase awareness of organizational improvements made in response to member and provider feedback.


Strategies such as these, along with a well-developed project plan that has shared accountabilities and alignment across an organization, will determine your success during the HEDIS season.

As you develop and finalize your 2017 HEDIS work plan, do you feel that you have the staff and analytic resources to execute it successfully?


Contact us today to learn how Centauri Health Solutions’ consultative advisory approach can assist your organization.
888.447.8908 • info@centaurihs.com • www.centaurihs.com