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Quality Measures Reporting

This report suite enables users to view both patient detail and LCU summary performance in key HEDIS measures addressing acute, chronic, and preventive care. The suite provides two types of reports:

  • The retrospective view (a rolling 12 months) includes a comparison to national and regional benchmarks. Ten measures and twenty one rates are produced in the retrospective view.
  • The prospective view (calendar year-to-date) enables the user to review current gaps in care and to identify patients needing outreach to receive services in compliance with guidelines by calendar year-end. Seven measures and twelve measures are produced in the prospective view.

This report is based on the Optum Impact Pro data mart and is updated monthly. The report suite contains both metric level and patient level information. Note that HPHC will be adding measures to this report suite.

The Metrics Report compares the provider group's current performance vs.

  • Prior year HEDIS performance
  • National 90th percentile and 75th percentile (most recently published by NCQA)
  • Regional 90th percentile and 75th percentile (most recently published by NCQA)
  • The number of patients needing to become compliant to reach the 75th or 90th percentile is displayed

The Member Detail Report identifies the each patient eligible for the measure (including demographic information), the PCP of the member, and their compliance status (1 indicating compliance).

These reports are available via HPHConnect. The Member Detail Report is also posted to the secure server.

The User Guide to Quality Measures Reporting provides more detail on accessing and using this reporting tool.