Back to Benchmark Home
Return to News & Events Home
News Article

DHIN Webinar Updates Providers on Scorecard and All Claims Database

June 5, 2018

Practice Transformation work — which is critical to helping Delaware providers convert their practices to meet the new pay-for-value mandates — began nearly three years ago as one of the Delaware Center of Health Innovation (DCHI) initiatives. The Common Scorecard displays 23 quality, efficiency, and cost-and-care measures for payers and patients and is important to transparency. In April, a DHIN webinar informed providers about the current use and future plans for the scorecard — along with giving updates on other important DHIN efforts.

Presenters Terri Lynn Palmer, project manager of DHIN; Angela Kaiser, MSN, CNL, RN, CMQP, clinical informatics officer of DHIN; and Ann Kempski, executive director of the DHCC explained the details of the current scorecard:

  • Current scorecard data are available on the online tool for the fourth quarter of 2015 through the third quarter of 2017 in quarterly increments.
  • Data include performance scores for the 23 measures and associated patients.
  • UnitedHealth Group dropped out at the contributing end of 2016 and is no longer a Medicaid MCO. New AmeriHealth Medicaid MCO, which began in 2018, has not yet contributed data.
  • Scores are presented as practice level scores compared with Delaware target scores.

Future changes to the scorecard include improved process efficiency:

  • The scorecard online application will be discontinued, and a static annual report will be delivered in its place.
  • The single data submission will include claims runout data for best possible annual score.
  • An annual report will include standard HEDIS measures only — nonstandard measures will be eliminated.

 

Providers also learned that the DHCC will use the data to publish a state scorecard, presenting the measures aggregated at the state level, comparing them to other states and the nation using HEDIS Quality Compass Data.

The webinar also engaged participants in a discussion about sending data to DHIN, and provided an update on the health care claims database. Presenters explained DHIN’s role — responsibility for developing the claims database to facilitate evidence-based improvements for access, quality, and cost using a single platform as a repository to house all data types. The database will include three years of historical claims from qualified health plans, Medicare, Medicaid, and the State Group Health Plan, as well as include pharmacy and medical claims in all care settings.

With this type of information becoming so important in both measuring performance and understanding all claims in the state, DHIN will continue to play a major role in Delaware’s Road to Value journey. Jan Lee, MD, CEO of DHIN, recognizes the importance of the data collection. “We will continue to advise Secretary Walker by providing data that can enhance transparency and shared accountability for spending and quality in our state.”