Closing Gaps in Care With Engagement and HEDIS Best Practices

Quality measures and scores from the Healthcare Effectiveness Data and Information Set, or HEDIS, are driving the need for not only a comprehensive roadmap that will close gaps in care, but also for a fine-tuned engagement methodology to help health plans and providers succeed in value-based care over the long term.

When Intelligent Engagement is applied to HEDIS care gaps, patients take action

At Carenet Health, our approach to healthcare engagement is known as Intelligent Engagement, a process rooted in human interaction, reliable data, advanced technology and engagement best practices from inside and outside of healthcare. This approach has been designed to address our clients’ HEDIS needs and help influence health plan members and patients to take the next best steps to improve their health and well-being. Those next steps typically include making (and keeping) an appointment with a provider to close a HEDIS-based care gap.

Tactics for HEDIS best practices

Our HEDIS engagement best practices are derived from 50,000+ daily consumer interactions and from supporting one in five Americans. For a typical health plan’s or provider’s needs, we recommend implementing at minimum these three proven engagement strategies.

1. Amplify every connection

To improve quality measure performance, every patient or plan member connection must address more than one objective. For instance, outreach communications should address multiple HEDIS measures per each interaction (if needed for that patient). Each touchpoint should also be used as a bridge to further build rapport and collect additional data.

2. Teach at every touchpoint

Education plays an essential role in quality healthcare and in encouraging individuals to schedule doctor visits and lab work. Effective HEDIS-related teaching involves being able to explain procedures and technical jargon in a simple way, as well as advising on the how and the why of those health needs. Perhaps most importantly, a core component of patient HEDIS education is being able to ascertain what’s keeping patients from closing their gaps in care and providing the information necessary to overcome those concerns, fears and barriers.

3. Coordinate care as needed

Coordination is invaluable in closing HEDIS and other types of care gaps. Outreach initiatives should always include an element of coordination—easily connecting patients with providers and health plan resources, as needed. Typically this is done through a three-way conference call. Coordination also requires providing multiple options for in-network provider selections.

Learn more from reading our HEDIS engagement best practices guide.

If you’d like to learn more about closing gaps in care through proven engagement strategies, be sure to download our popular HEDIS best practices guide.