HEDIS Member Outreach
| To: | Health Plan of San Joaquin (HPSJ) Providers |
| From: | Provider Services Department – Health Plan of San Joaquin |
| Subject: | HEDIS Member Outreach |
| Products: | Medi-Cal Managed Care |
It’s HEDIS time for our HPSJ provider network and members.
During the fall of each year HPSJ reaches out to those members who are not meeting certain HEDIS criteria. We want to give you a heads-up that you are likely to receive requests from these members for appointments as a result of calls during the coming week, as well as letters that will go out shortly from HPSJ.
Please accommodate these HPSJ members who contact you for an appointment so they can be seen before the end of December.
What is HEDIS? – A Recap
The Healthcare Effectiveness Data and Information Set (HEDIS) is the most widely used array of performance measures in the United States health care delivery system. HEDIS was developed and is maintained by the National Committee for Quality Assurance (NCQA). The performance measures in HEDIS are related to many significant public health issues such as cancer, heart disease, smoking, and diabetes. The State of California Department of Health Care Services (DHCS) uses the HEDIS measures to evaluate health issues and health plan performance.
HEDIS-related services include:
- Cervical cancer screenings
- Diabetes care
- Immunizations
- Medication management for asthmatics
- Well child visits
As you now are well aware, those same HEDIS measures that allow HPSJ to measure quality and effectiveness of care also enable HPSJ to reward our providers for their efforts through our incentive program. We thank you for your continued partnership in delivering the highest quality of preventive and effective care for our members who are your patients.
If you have any further questions, please contact our Provider Services Department at (209) 942-6340.