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Accelerate HEDIS Gap Closure by Removing Barriers to Member and Provider Engagement

Addressing HEDIS Gap Closure with Member and Provider Engagement

As preferred vendors for the Association for Community Affiliated Plans (ACAP), we were honored to have the opportunity to present a webinar on how health plans can accelerate HEDIS Gap Closure by Removing Barriers to Member and Provider Engagement.

In our previous webinar on how health plans address barriers to engaging Medicaid members, we spoke about the importance of finding strategies that allow plans to proactively identify and resolve members issues throughout their entire lifecycle. In this year’s webinar, we build upon these challenges and approach ways in which both member and provider engagement help close gaps in care and help meet HEDIS benchmarks.

A Different Approach to Meeting HEDIS Goals
During the webinar, Shawn Lemerise, Executive Vice President and Managing Partner for CipherHealth shared how managed care organizations and care providers across care continuum leverage CipherHealth’s technologies to engage members throughout their entire care journey to improve outcomes and experiences. With customized call, text, and email programs coupled with recorded care instructions and a care management platform, there are many ways health plans can improve organizational performance.

Alyson Fisher, Account Executive at CipherHealth then discussed how health plans can take a new approach in meeting HEDIS measures. Instead of relying upon analytics to play a numbers game, Van Reesema invites plans to think of people and communication as valuable tools in accelerating HEDIS metric closure. To properly leverage these resources, it is key to develop processes and procedures that support members with education in their language, at the right time, with the right message.

As Fisher showcases, HEDIS measures have an immense impact on plans. From increase revenue and auto-assignment to strengthening provider networks, HEDIS measures provide a path to success for nearly every plan. To become a top performer, health plans must focus on successfully closing gaps in care and help members find and utilize the appropriate health resources. This takes a coordinated effort between the plan, the provider, and the member.

Understanding Roles & Responsibilities in Closing Care Gaps
To understand this effort, Friso van Reesema, VP of Business Development at CipherHealth, discusses the RACI model to highlight who is responsible, accountable, consulted, and informed throughout the process of identifying the member, closing care gaps, and leveraging data to drive further improvements.

Elaborating upon the challenges that health plan’s face during each step of closing care gaps, Van Reesema provides many strategies for how member and provider engagement can be solutions and successfully overcome many barriers plans face.

Although there are many barriers to accelerating HEDIS care gap closer, member and provider engagement provide a plethora of opportunities to achieve desired results. To hear more, access the webinar, and read on to see how CipherHealth can work with you to develop and implement an effective member engagement program.


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