MEET CMS HEDIS 5-STAR RATING
With Pure4 HEDIS Campaign Management Process
Tampa, FL. June 14th, 2022.
Although Center for Medicare and Medicaid Services (CMS) offers incentives to insurance companies to meet screening targets under HEDIS program and most insurance companies have some form of eye checks campaign in place for people with diabetes, these campaigns are often not adequately resourced or organized systematically as a screening pathway. For that reason, many people with diabetes are living with preventable vision impairment and blindness.
5-Star multiple health plans have met CMS 5-star ratings which requires 78% of the eligible population to be screened
the payers for completing CMS screening targets.
the conditions without detection and treatment.
Provider/ PCP Impact
QIP (payfor-performance program) measurement set which is aligned with HEDIS. Compliance with HEDIS measures would help increase QIP score.
Constellation4 with a mission to improve patient health has built a campaign management solution for HEDIS quality Managers to deploy a screening pathway and meet their annual CMS HEDIS targets. Our Pure4 Solution has below capabilities to run and manage the campaign.
Step 1: Identification
sent for at home screening by geographic area.
Step 2: Invitation & Information
Step 3: Testing & Reach Out
Step 4: Scorecard
the screening program.
Health Plan Open Gaps
Gaps To CMS %-Star Goals
How To Get Started
Founder & CEO
VP of Data Science & Analytics
Constellation4 Health is a Healthcare technology company providing innovative and scalable solutions for leading Health Insurance Payers and Providers. Solutions include:
Automate and mature your Data Science, Predictive Analytics and AI. We have over 100 Use Cases including claims reconciliation, profitability analysis, and HEDIS Campaign Management.
Provider Data Management
A single source of truth for provider data powered by a Data as a Service platform that ensure 92% data accuracy compared to an industry standard of 52%.
Provider Network Management
Reimagining the workflows between payers and providers is a must to create sustainable payer models. A complete contact to contract platform powered by Salesforce.
Referral Care Coordination
Our seamless physician to physician referral platforms grows market share, prevents leakage and enables providers to have complete visibility on patient status.