New HEDIS Offering Boosts Quality and Encourages Member Health Through Prevention, Early Detection, and Chronic Condition Management.
June 04, 2013 – BioIQ has announced a patient-outreach solution that helps Accountable Care Organizations (ACOs), Medicare Advantage programs and other health plans improve their Healthcare Effectiveness Data and Information Set (HEDIS) measures. BioIQ streamlines the process of fulfilling HEDIS mandates and increasing Star ratings by providing members with the preventive and chronic care that they need to stay healthy. The solution helps these organizations boost their HEDIS scores and Medicare Star-ratings by screening their populations for diabetes, heart disease and cancer. Over the last year, BioIQ has conducted programs with several prominent organizations, including one of largest health plans in the country.
iCare, a Coordinated Care Organization in Milwaukee, is currently launching its third BioIQ program. Sandra Holmes, Director of Network Development at iCare, was pleased to report a significant boost in its HEDIS Star ratings as a result of these programs.
“We had to look at alternative ways to ensure that our members were completing the measures that they needed,” said Holmes. “BioIQ helped us automate key parts of the HEDIS measurement process including physician outreach, lab requisitions, and results reporting. The BioIQ colorectal screening campaign resulted in a one-star jump in our initial, claim-based estimate of our star rating. This was the first direct population-based campaign that we have tried and we were very happy with the results.”
BioIQ simplifies the HEDIS compliance process with a closed-loop system for contacting members, guiding them through the health screening process, generating lab results, creating electronic health records and integrating the data with the health plan’s back-end systems. Participating organizations simply supply an eligibility file containing information about members who are out of compliance. BioIQ contacts these members and makes it easy for them to sign-up, online or over the phone. Each participant receives simple instructions for getting screened at a nearby lab, via a home test kit, or with help from a caregiver. Via a secure portal, these members can view lab results and receive targeted recommendations for discussing those results with a primary care physician. To drive participation, BioIQ sends a series of invitations, alerts, and reminders by phone, mail, email, SMS, mobile, and Interactive Voice Recording (IVR) mediums.
HEDIS is a tool used by more than 90 percent of America’s health plans to measure performance on important dimensions of care and service, including how many of their members receive preventive health screenings. Health plans offering Medicare and Medicaid Services must identify members who are out of compliance and encourage them to receive testing, follow up and treatment. The U.S. Centers for Medicare and Medicaid services (CMS) determines premiums and bonus payments based on the resulting HEDIS scores, which will soon be tied to Medicare Star ratings. BioIQ’s extensive experience collecting health data and screening large populations uniquely positions it to address these Federal requirements.
“This is a huge opportunity, not only for helping health plans to be more competitive, but also for demonstrating the potential of population health management,” said Justin Bellante, CEO at BioIQ. “With more than 100 million Medicare/Medicaid beneficiaries, large employer populations, and growing ACOpopulations, engaging and testing members is a win-win for everybody.”
BioIQ is a health improvement technology company that has implemented the industry’s first integrated, customizable and measurable approach to optimizing investments in corporate health and wellness programs. The company’s unique health screening platform, ecosystem of health improvement tools, and proven methodology for obtaining quantifiable wellness insights are serving beneficiaries across the United States. BioIQ works with some of the largest employers and health companies in the nation and has launched over 2,000 successful health improvement programs since its inception in 2005.
Press Contact: David Baum
Director of Communications, BioIQ