We’re committed to earning a 5-Star rating for our Medicare Advantage plans’ clinical and experience goals each year. As our partners, we need your help supporting our goal of delivering high-quality care for our members.
STARS SPOTLIGHT
Participate in HEDIS MRR chart requests
The HEDIS medical record review (MRR) season has kicked off. If you are not working directly with your Devoted Health network team for chart retrieval, you may hear from our partners at Datavant (formerly known as CIOX). We chose Datavant as our partner for medical record retrieval because we know some providers may already work with them via other plans. We are concluding our MRR season at the end of April.
Emphasize importance of colorectal and breast cancer screenings and ensure patients are up-to-date
Clearly document past medical and surgical history in patient’s medical record, including surgical and diagnostic procedures, dates, and results
Submit claims and encounter data in a timely manner
Consider standing orders to allow clinical staff to initiate screenings
Patient may be eligible for Devoted Dollars for the screening
Colorectal cancer screening (COL-E)
GOAL: Provide appropriate screening for colorectal cancer.
What counts:
Colonoscopy in the last 10 years
Flexible sigmoidoscopy in the past 5 years
CT colonography (virtual colonoscopy) in the past 5 years
Stool DNA with FIT test in the past 3 years
Fecal occult blood test (FOBT) annually — tests performed in an office setting or on a sample collected via DRE are not specific enough and don’t count
Breast cancer screening (BCS-E)
GOAL: Provide a mammogram to screen for breast cancer between October 1 two years prior to the measurement year through December 31 of the measurement year.
What counts:
Screening, diagnostic, film, and digital breast tomosynthesis mammograms
CAHPS MEASURE SPOTLIGHT
Make sure patients get care quickly
Here are ways to help improve this measure:
Help patients make specialist appointments before they leave your office
Suggest patients make routine and follow up appointments before they leave your office
Explain any long delays and share appointment expectations with patients, especially how long it might take to see a specialist
Open same day appointment slots
For urgent issues, offer appointments with a nurse or physician’s assistant
The CAHPS survey is live
The CMS-led CAHPS (Consumer Assessment of Healthcare Providers and Systems) member experience survey is currently underway and will continue through June. Providers and care teams can positively impact survey outcomes by ensuring timely access to care and coordinating care with specialists.
Watch for the updated provider scorecards
The Q2 provider scorecards will be available in April, with scorecard performance conversations occurring with provider groups in May and June. The primary focus will be on performance and member outreach. The panel list criteria has moved away from risk-based assessments, and aims for more actionable outcomes for patients.
Call us at 1-877-762-3515 TTY 711 (Monday to Friday, 8am to 5pm). We’re here to help.
CONFIDENTIAL - For provider use only. Not to be shared with Medicare beneficiaries.
Devoted Health is an HMO and/or PPO plan with a Medicare contract. Our D-SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal.
Devoted Health, Inc., PO Box 211037, Eagan, MN 55121
