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Author Question: Explain the use of performance measures, such as HEDIS, by an MCO.[br][br][b][color=#347235]Question ... (Read 21 times)

panfilo

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on: Jul 12, 2018
Explain the use of performance measures, such as HEDIS, by an MCO.

Question 2

What types of statistics are utilized by an MCO?


macagn

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Reply #1 on: Jul 12, 2018
Answer to Question 1

HEDIS allows employers to compare health plans, understand the value of what their health care premium is purchasing, and hold the health plan accountable for performance against these measures. HEDIS measures areas such as effectiveness of care, access/availability of care, satisfaction with experience of care, use of services, cost of care, and health plan stability. Using a performance measure allows MCOs to benchmark against other MCOs.

Answer to Question 2

Per Member Per Month, Per Contract Per Month


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