Medicare Advantage (MA) has exploded over the last 10-15 years, with the number of beneficiaries increasing by almost 400 percent in that timeframe. Provider groups have an increasing percentage of revenue and patients in MA plans and providers
are increasingly compensated based on HEDIS quality measures and risk scores through a combination of claims data and supplemental data. Submitting supplemental data can be critical to ensure providers receive credit for the quality of care they deliver and the true complexity of their patient population. Some plans have well-defined reporting programs, while others have little-publicized channels for reporting supplemental HEDIS and risk data. There are also significant bonuses that MA plans offer to providers for reporting, since the plan benefits immensely from receiving the data.
In this article, you’ll learn:
Why is HEDIS and risk data so important to health plans?
What is supplemental data?
And how do you as a provider organization report this data efficiently to earn incentives?