NCQA has simply launched its 2023 well being plan scores. These scores are based mostly on well being plans that publicly report their high quality measures (by way of the Healthcare Effectiveness Knowledge and Info Set – HEDIS®) and represents about two thirds of all the US inhabitants.
General, there’s a slight enchancment in efficiency from well being plans versus 2022 – particularly round well being fairness – the place 92% of plans reported the direct race and ethnicity measure – scoring most factors on this measure.
Two industrial plans acquired 5-star scores – Kaiser Basis Well being Plan of the Mid-Atlantic States and Unbiased Well being Affiliation (which is up from 1 plan final 12 months). No Medicare or Medicaid plans acquired 5 stars this 12 months.
With these scores now launched, we are going to eagerly anticipate the October launch of 2023 Stars scores to see if drop in efficiency final 12 months was a “blip”, with restoration this 12 months or if extra plans will see the submit covid impression on their scores.
No matter general traits, if you’re a well being plan trying maximize your scores, my sturdy recommendation is that you just flip to expertise and AI options to make sure you are reporting precisely – and never being penalized for care gaps that exist on paper however not in apply.
How do you do that? With AI assisted medical report evaluation – as a well being plan, you may enhance the quantity and accuracy of supplemental information or digital information you evaluation and submit as a part of your high quality reporting. This use of such expertise has seen well being plans and ACOs enhance effectivity of medical report reconciliation and evaluation by over 10x.
As we method HEDIS® season – it isn’t too late to make the increase you want with NLP.
If that is of curiosity to you – then please get in contact.
Linguamatics 
21 Sep 2023