HEDIS/QARR

NYCHSRO/MedReview has conducted HEDIS/QARR reviews for several clients over the past eighteen years. The key to our success is the quality and accuracy of our medical review team.

WHAT IT IS:

  • QARR stands for Quality Assurance Reporting Requirements

  • QARR is the New York State Department of Health’s version of HEDIS, which is the national Health Plan Employer Data and Information Set

  • QARR is a set of performance measures that health plans must report, on an annual basis, to NYSDOH under Medicaid, Family Health Plus and Child Health Plus

  • QARR data includes performance measures related to many preventive health conditions and services such as cancer, heart disease, depression, hypertension, asthma, diabetes, well care visits and age appropriate immunizations, etc.

HOW IT WORKS:

  • MedReview conducts both in-house and on-site HEDIS/QARR measure specific data collection and performs the clinical review

  • Reviews are conducted by Registered Nurses with at least three years of experience and training in New York State’s Health Information System data abstraction

  • All abstracted data collected is 100% quality assurance reviewed

  • MedReview specializes in large health care systems as well as small single physician practices and has had extraordinary success in restoring non-compliant sites to full compliance

  • Once “pull lists” are generated, site visits are scheduled in a timely and professional manner with individual record and review integrity maintained until transferred to the client

  • MedReview’s completed audits and recommendations and assist plans in obtaining higher scores on performance measures.

  • MedReview provides weekly updates to our clients on the status of the review process

  • Each client is assigned a program manager who will be there liaison throughout the project. Each client also has dedicated RN’s that are assigned solely to their project

  • MedReview is available to assist Health Plans with Pre-QARR reviews, and Quality projects throughout the year.

For more information, click here.