The latest on managing care, value-based care, insurance markets, payers & providers

A medical center improves its HEDIS scores

The leaders of Kaiser Permanente San Diego Medical Center didn’t think they were scoring high enough on nine HEDIS measures. Though the center was competitive nationally (above the 90th percentile on six of the measures and within three points of the 90th percentile on three others) it was among the lowest in Southern California.

“Clinical champions” (often specialty department heads) were asked to address the problem, and they set about showing doctors and support staff how to ensure that patients got the care they needed whenever they encountered the health care system. For example, a woman taken to the emergency department might be asked when she last had a mammography.

“In one instance, the clinical laboratory reported that every month, stool samples for colorectal cancer were often discarded because of illegible labeling by patients. A simple fix was to ensure that sample containers were labeled before distribution to patients.”

Performance on selected HEDIS measures improved by 1 to 8.6 percentage points.

HEDIS measure*

*Derived by dividing the number of people who received a service by all of those eligible for it.

Source: “Redesigning Chronic and Preventive Care to Provide a Regional Safety Net,” the Journal on Quality and Patient Safety, November 2013

Subscribe to Our Newsletters

Monthly table of contents

Be notified as each issue of Managed Care is available online.

Biweekly newsletter

Recent topics have included:

  • Doug Jones and the ACA, Epic misses a White House meeting, and man caves for man-flu sufferers
  • CVS-Aetna deal may trigger merger mania, Johns Hopkins criticized for lack of asthma prevention, & Columbia sees free-ride future for all of its med students

PTCommunity news

New drug approvals, clinical trials, drug management. Three times per week.