Faster and Better Intervention for OMW and Similar Measures

Apr 29, 2021 | Solutions

Every HEDIS measure is different. And in a subset of HEDIS measureswe know that time is of the essence. For example, the Osteoporosis Measure in Women (OMW) has been a particularly difficult measure for most health plans to improve on. Astrata’s Monitor product can help.

Osteoporosis Management in Women Who Had a Fracture:

Assesses women 65–85 years of age who suffered a fracture and who had either a bone mineral density test or a prescription for a drug to treat osteoporosis in the six months after the fracture.

Why are measures like OMW so difficult? 

For most health plans the definition of the denominator (women 67-85 who have had a fractureis determined by claims which must be received, loaded into the Health Plan’s HEDIS engine, processed, and then reported out to the relevant health care provider or to the Health Plan’s Quality Intervention or Care Management teams. But that set of processes can take months on average. When your window is short, your providers and intervention teams are in a race with time to close that gap.   

Other HEDIS measures with short time windows include many of the behavioral health measures, including FUH, FUM, FUA, FMC, and ADD. 

Engaging members in their healthcare 

Another thing that makes these gaps so hard to close is that member motivation and engagement are not constant over time. As a fracture heals, or the memory of an ER visit fades, your members may feel less inclined to agree to interventions that could reduce the risk of similar events in the future. That’s why acting quickly is so important. And Astrata’s technology provides the clinical data and insights you’ll need to act rapidly. 

In a recent test of Astrata Monitor at a large payerprovider system, use of Monitor was associated with an increased BMD scheduling rate from 39% to 59%. Extrapolating across an entire year, this change will produce more than a one-star increase for this organization. 

Surveillance Measures 

At Astrata, we call measures like OMW, FUH and FUA Surveillance Measuresand Astrata Monitor is a unique product to help you monitor your populations and quickly identify these gaps. Now your QI or CM teams can intervene fastereven before the claim comes in. 

It’s all in the Data 

If your organization is already bringing in EMR data and clinical notes to fuel your yearround HEDIS program or for prospective Risk Adjustment, you can increase the value further by adding ongoing member surveillance for time-bound measures.  

Read this next…

What one year of ChatGPT has taught me about the future of Quality measurement – Part 1. The AI HEDIS Analyst

It’s been over a year since the release of OpenAI’s ChatGPT. And this is my first blog on the topic of how I think this new technology will fundamentally change healthcare Quality measurement and improvement. Why the wait? With the extraordinary flurry of activity,...

Quality Navigator – a first-in-breed QI solution

This month we're diving deep into a brand new Astrata offering - an archetypal, first-in-breed product with transformational potential for value-based healthcare. Quality Navigator represents the third product in Astrata’s overall quality solution suite, tying ...

Take Prospective HEDIS to the next level with an effective leads program

For those Health Plans that are already implementing a prospective, measurement-year program to close HEDIS gaps across your populations – know that you are taking one of the most important first steps towards Digital Quality, by realigning your workforce to a...

Six Reasons to Start Your Digital Transformation with Prospective HEDIS® Review

Navigating the transition to Digital Quality is like crossing a fast-moving stream. You want to get across without falling in and getting washed away! You may not know how long it will take to get across, but you don’t want to be stuck on the shore when the water...

Tackling Prospective HEDIS Review – Tips and Tricks

Many payers are either experimenting with or fully implementing a prospective HEDIS review process. If you're looking for strategies to optimize your prospective review, these ten tips and tricks will help you derive maximal value. Many payers are either experimenting...