Simplifying HEDIS®: how intelligent automation gives you more time

Navigating the complexities of HEDIS

Every HEDIS season, health plans and risk-bearing providers face an incredible challenge: how to collect and aggregate mountains of data, make sense of that data, and report on it with a high level of confidence against a looming deadline. Despite the complexities of navigating HEDIS season, intelligent automation (IA) offers promising results for healthcare organizations.  

IA supports the work of medical coders and abstractors, expanding their productivity to accomplish more in less time. Leveraging IA during HEDIS season is not only a nice-to-have – it may be the only way to accelerate and simplify workflows enough to remain competitive in a value-based care environment.

Intelligent automation for a simpler HEDIS season

IA uses technology like artificial intelligence and machine learning to drive process improvements, automating complex workflows and tedious tasks that previously had to be completed manually. In the world of HEDIS reporting, IA is a game-changer. Previously manual, cumbersome processes can now be automated – with incredible precision – taking the administrative hassle out of HEDIS reporting and helping teams focus their energy into closing gaps in care.

Automated medical record retrieval

Accessing clinical data from providers can be one of the most challenging and time-consuming tasks required for HEDIS reporting. It requires the work of retaining provider permission as well as a technical lift to extract and process thousands of charts in a short window of time.

Fortunately, IA can carry the bulk of this work. With the right technology, value-based care focused organizations can collect medical records up to 80% faster. One firm, for example, used automated outreach workflows for HEDIS provider outreach. Using IA, the firm’s staff no longer needed to conduct manual uploads, spreadsheet reconciliation, or call providers. As a result, they experienced a 50% improvement in outreach efficiency and delivered packets to providers three weeks faster than before.

Highly accurate data aggregation

Once medical records are retrieved, risk-bearing organizations must match those charts to the chase lists. Medical records arrive from providers in various formats. To take advantage of IA, this clinical data must be converted into a digital format   – all while balancing interoperability and data privacy.  

Unfortunately, the process rarely yields the complete picture necessary for HEDIS reporting. Not all data types translate into the appropriate digital format, and unstructured clinical notes are notoriously difficult to extract. IA can close data gaps to create a more complete and accurate reporting of HEDIS activities, flagging items that require follow up including potential discrepancies in coding.  

For one firm using IA to support HEDIS reporting, the technology was able to flag validated addresses so that coders could focus on potentially inaccurate addresses. This significantly streamlined manual verification for a faster overall turnaround time.

Beyond simplification – transforming HEDIS season

IA has the power to simplify an otherwise complex HEDIS season – and it can do so much more. Incorporating the technology into organizational systems facilitates a year-round approach to quality, empowering value-based care organizations to reduce costs and improve patient outcomes with speed and adaptability.  

Consider simplifying HEDIS season with IA for greater success in quality improvement year-round. Request a demo of Reveleer’s platform today to see how IA can simplify your HEDIS season.