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Monday, October 18, 2004 - 10:35 AM
1

Gleaning Registry Information for HEDIS encounters

Bobbie Brogan, Clinical Quality Management, Amerigroup Corporation, 4425 Corporation Lane, Virginia Beach, VA, USA and Michael Musci, Managed Care Services, AMERIGROUP Corporation, 4425 Corporation Lane, Virginia Beach, VA, USA.


BACKGROUND:
AMERIGROUP Corporation provides access to EPSDT (Early and Periodic Screening, Diagnostic and Treatment) services to children ages 0 thru 20 (0-21 in DC) years of age by contractual requirements in all states in which the company provides services. These comprehensive services are federally mandated benefits available through medical assistance departments in states (Medicaid).

OBJECTIVE:
The EPSDT Datamart also incorporates immunization registry linkages from external sources. EPSDT Datamart successes include immunization registry linkages with: District of Columbia (DC), Illinois (IL) Healthy Kids, Illinois Cornerstone and the New Jersey DOH.

METHOD:
AMERIGROUP invested time and financial resources to build a unique EPSDT Datamart to improve data integrity for member and provider mailings. The Preventive Health Reminder Card Program sends each member (all ages) a birthday card which reminds the member to schedule a “well-care” exam. The customized card lists specific screenings needed. The Preventive Service Reminder Postcard Program sends each member (ages 0 – 20, except 21 in DC) a reminder postcard ninety days after their birthday to remind them to schedule a well-care exam and appropriate services if no claims have been recorded. Providers receive a monthly report informing them of members in need of a well-care exam and/or appropriate screenings.

RESULT:
Project impacts are DC pneumococcal vaccine rate increased by 308%, adolescent immunization rates increased by 160%, IL chicken pox vaccine rate increased by 69% and measles, mumps and rubella increased by 73%.

CONCLUSION:
AMERIGROUP has the ability to replicate the information technology data pull from state to state to define standard formatting results with no additional fees by HEDIS vendor to incorporate files.

LEARNING OBJECTIVES:
To teach others how to incorporate state immunization registries for HEDIS outcomes.

[ Recorded presentation ]   Recorded presentation

See more of Challenges and Changes in Registry Operations
See more of The 2004 Immunization Registry Conference