RAF
Stars
HEDIS
Validation
Member Experience
100

Members should be evaluated this often for all disease burdens

Annually

100

It is a continual challenge to reach higher than three stars in this measure

Colorectal Cancer Screening

100

Through Health Net MediCal, women are eligible for a $25 gift card for completing this screening

Cervical Cancer Screening

100

Double Jeopardy Validation! Name the following:

1. This adorable character's full name

2. What the "RA" stands for in a RAD-V audit 


1. Sponge Bob Square Pants

2. Risk Adjustment

100

Happy members are MORE likely to do this

Be compliant with treatment plans

200

These three elements are required to submit a condition for RAF calculation

Diagnosis

Status

Plan

200

Women may be excluded from the Breast Cancer Screening measure for this reason

Bilateral Mastectomy or Unilateral Mastectomy x2

200

Double Vision!

This actress has both:

1. Twin Sisters

2. Played the wife of Vision

Elizabeth Olsen

200

TRUE or FALSE

Presence of a medication list including Prozac is sufficient to demonstrate a treatment plan for a diagnosis of Recurrent Major Depression, Mild in Severity

FALSE

200

This simple instruction helps bring your visit to a close so the patient knows what to expect

Example:

Thank you for coming to see me, my nurse will be right in with your after care instructions

300

True or False

RAF from disease categories is additive

True

300

DOUBLE JEOPARDY!

Name the two Care of Older Adults (COA) measures

Pain Screening

Medication Review

300

For measurement purposes, Breast Cancer Screening should be done on this population and this frequently

Women 50-74, at least every other year

300

TRUE or FALSE

A reported diagnosis does not have to be documented in the chart note


FALSE

300

TRUE or FALSE

Member experience measures are triple weighted

TRUE!

400

Double Jeopardy!

This organization, formed 04/01/1918 and also abbreviated RAF is what?

Royal Air Force

400

This is the threshold (%) a member must reach to be considered compliant with the Proportion of Days Covered (PDC) Part D measure

80%

400


The Timeliness of Prenatal Care measures states pregnant women should be seen within this timeframe


First Trimester

400
TRUE or FALSE


Referencing an abnormal monofilament exam of the extremities is sufficient to establish a diagnosis of Neuropathy

TRUE

400

This character is known for being anything but patient

Donald Duck!

500

DOUBLE JEOPARDY!

Higher RAF indicates this, where as lower RAF should indicate this

Higher RAF = Sicker Patient

Lower RAF = Healthier Patient

500

Star sighting!

Which of these mustached men is Alex Trebek?

(Left, Center, Right)

Center

500

Children ages 3-18 should have this within the seven day window surrounding the initial diagnosis of Pharyngitis

Group A Strep test

500

Your 80 year old male patient is there to establish with you. He's a robust man and states he has a history of RA, but he only takes Tylenol for the pain. This is your diagnosis.

NOT RHEUMATOID ARTHRITIS

Run Labs

Send to Rheumatology for confirmation

500

DOUBLE JEOPARDY!

List three things you can do to make a patient feel like you listened to them and care about their health

Smile

Make eye contact

Use their name 

Ask about their family or interests (be specific)

Shake their hand (bump elbows, etc.)

M
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