HEDIS
A paperless, digital and computerized system of maintaining patient data.
What is an EMR (electronic medical record)?
2024 Medicaid Health Plan Rating
What is 3.5 stars?
What CAHPS stands for
What is the Consumer Assessment of Healthcare Providers and Systems?
Number of team members in QI?
What is 18?
3 types of member interventions
What are member education, member rewards, and member outreach calls
HEDIS measures that contain different combinations of shots to keep members healthy
What are Immunization Measures?
Medicare star rating for 2024
What is “3 Stars”?
Month that the CAHPS survey goes out to members
Annually between February to June
Pillars of QI
What are Provider Engagement, Compliance, Analytics and Quality Interventions
The number of provider groups that are in our Medicare P4P
What is 52 or over 50?
WCC, LSC, IMA, CCS, CBP, COA, GSD, TRC, PPC have this in common
What are the 2025 Hybrid Measures?
An initiative that is a concentrated effort on a particular problem in one area or measure. It involves gathering information systematically to clarify issues or problems, and then developing intervening for improvements.
What is a PIP?
2 types of Medicaid CAHPS Surveys
What are Adult and Children with Chronic Conditions?
Who is the newest QI team member?
Abby
Solutran
What is the vendor that Molina WA uses to reward Medicaid Members for completing health care services?
FUA
What is Follow-Up After Emergency Department Visit for Substance Use?
Weighted Medicaid Withhold Measures for 2024
What are BCS-E, PPC, AMM, ADD-E, FUH, FUA and WCV Age 3-11?
Category for “Getting urgent care” and “Getting routine care”
What is Getting Needed Care?
This is a statistical process that adjusts payments to healthcare providers based on the health conditions and characteristics of their patients.
What is Risk Adjustment
3 Types of Provider Interventions
What are VBCs, Quality Incentives, and Actionable Reporting?
Documented Assessment After Mammogram (DBM-E); Follow-Up After Abnormal Breast Cancer Assessment (FMA-E) and Blood Pressure Control for Patients with Hypertension (BPC-E)
What are the 3 new HEDIS measures for 2025?
What NCQA stands for?
What is the National Committee for Quality Assurance?
What year was the first CAHPS survey released for health plans?
What is 1997?
QI team members that live outside of Washington state
Amy (OR), Kate (AZ), Kristy (OR), Glenisa (NV), Binita (NJ), Lindsey (WI)
Who is responsible for quality improvement?
Who is “everyone”?