Moving the needle with Digital Quality: Practical Advice from Industry Insiders-August 15th-3:00 EST
April 29, 2021 | AI and NLP
Faster and Better Intervention for OMW and Similar Measures
Every HEDIS® measure is different. And in a subset of HEDIS® measures, we 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.
Rebecca Jacobson, MD, MS, FACMI
Co-Founder, CEO, and President
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 fracture) is determined by claims which must be received, loaded into the Health Plan’s HEDIS® engine, processed, and then reported out to the relevant healthcare 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 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 payer–provider system, the 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 Measures, and 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 faster, even 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 year–round HEDIS® program or for prospective Risk Adjustment, you can increase the value further by adding ongoing member surveillance for time-bound measures.