NCQA’s HEDIS measures are the de-facto standard for health insurance providers to measure clinical quality and outcomes. Traditionally, HEDIS measure specifications have been made available by NCQA certified vendors towards the end of the measurement year. This leaves health insurance providers with no time to react & adjust outreach strategies. Starting HEDIS 2022, NCQA plans to advance the publication of specifications by a year. This means health insurance providers will receive certified measures midway through the performance year, giving them 5to 6 months to adjust member engagement & provider outreach strategies.
This webinar will lay out upcoming impacts to measure publishing, vendor certification, & health insurance provider release of certified measures. It will present strategies to optimize your approach to internal and external coordination across programs, increase scores, and improve coordination to drive a comprehensive program for quality and risk. The speakers will also highlight how a mature solution can help improve efficiency and transparency, reduce abrasion, and collect data proactively – thereby reducing the need to chase providers and charts.
BlueCrossBlueShield North Carolina
Brad Wilson served as President and CEO of Blue Cross Blue Shield of North Carolina for almost 8 years, capping a 22-year career with North Carolina’s largest health insurer. Under his leadership, BCBSNC grew to a $9 billion company serving over 3.8 million customers. Prior to BCBS North Carolina, he has served as Director of the BCBS Association, AHIP and numerous other national and state healthcare organizations. He also served as General Counsel to Governor James B. Hunt where he directed the governor’s legislative strategy, led the legal office and served as a cabinet secretary. Brad holds a B.A. degree from Appalachian State University, an M.A. degree from Duke University and a law degree from Wake Forest University.
Sr. Vice President
Product Management, CitiusTech
Jeffrey Springer has more than 20 years of healthcare industry experience, having worked with leading healthcare technology vendors. He is credited with founding the first payer-provider contract management company in the US. Currently with CitiusTech, he drives the product management, business analyst and product strategy for all products and solutions. Prior to CitiusTech, Jeff led the product management and strategy for analytics at Siemens and care management and analytics at MEDecision. He also ran a business unit at McKesson to develop new products working with payers & providers. Jeff holds a Mechanical Engineering Degree and an MBA from the Wharton School of Business at the University of Pennsylvania, where he graduated as a Palmer Scholar in the top 5% of his class.