Q&A: Health Risk Assessment, HEDIS and Star Ratings, and Health Outcomes

by Jessica Wahaus on July 28, 2015

As the fourth quarter of the year nears, reaching as many members as possible to improve health outcomes and meet quality measures becomes increasingly urgent.

In 2012, ExamOne, a Quest Diagnostics company, began partnering with several health insurers who wanted to take their diabetic quality measures into their own hands. They sought flexible options to help physicians and members obtain necessary testing before their year-end deadline. The custom solutions that provided proactive health risk assessments and strategies to boost HEDIS and Star measures ultimately expanded beyond diabetes and evolved into MediCheck™.

Now three years later, MediCheck has grown into an excellent example of combining the strengths of Quest Diagnostics and ExamOne for the benefit of our clients. In the following Q&A, MediCheck’s Director of Operations, Peter Wilkinson, discusses the most frequent questions he receives about our unique offering.

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Q: Annual exams or health assessments are an important part of a strategy for improving HEDIS measures. How does MediCheck work with members to fulfill these assessments?

P: Many health plans face this question: how can they get diabetic members to comply with annual testing so the plan can improve HEDIS scores and health outcomes for the members? When we looked at this challenge, we focused on overcoming it by making the process easy for the member. With MediCheck, our telephonic outreach and engagement, mobile phlebotomy and assessment program, we’ve simplified the process for the member – by going to the member’s home.

This applies not only to diabetic members. MediCheck can complete a full lab panel to give health plans access to the data and insights needed to manage member health conditions and improve HEDIS scores in a number of different areas, including adult BMI assessments, colorectal cancer screening and blood pressure control.

Q: Another challenge in gathering member health data is obtaining the physician orders for biometric collection. How does MediCheck obtain these orders?

P: MediCheck utilizes a physician authorization and alert calling company that helps create more encounters for members by taking responsibility for the lab orders and test results. We provide the primary care physicians with the results; we just don’t burden them with an inefficient process of contacting them to retrieve individual test orders for members.

Q: What role does this type of risk assessment play in member satisfaction and health outcomes?

P: MediCheck connects the data from each stage of the assessment and produces a complete report for the member, the primary care provider and the health plan. If a health plan is using our full program, which includes a second visit from a nurse practitioner, our licensed nurse practitioners meet with members one-on-one in their own homes to gain a deeper evaluation of health risks and wellness education. According to results from our member satisfaction survey, eight out of 10 members became more aware of their health, and more than 95 percent would recommend the MediCheck process to a family member or friend. The result of our program is the ability for the health plan to identify potential disease states, and drive toward an improved health outcome for the member.

Q: What is the result at the end of the day?

P: By calling and visiting members, we’re able to reach many people who are not aware of their health risks. We’re able to give them the information they need to make changes and improve their health. In 2014, MediCheck conducted 270,000 outreach calls to nearly 59,000 health plan members, completing 6,500 in-home screenings. This year, we’ve already completed screenings for more than 9,400 members on behalf of health plans concerned with their HEDIS measures, and the bulk of our outreach campaigns won’t begin until August. In addition, MediCheck clients have started implementing programs earlier in the year, recognizing that going to the home is vital and that the people who benefit from the program the most are those who aren’t going to see their doctors on a regular basis, and who may avoid testing altogether.

For more information about MediCheck, call 855.324.7468 or email MediCheck@ExamOne.com.

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