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Monday, October 18, 2004 - 3:55 PM
2

Being a Matchmaker: Health Plans' HEDIS efforts and SDIR

Anne Cordon1, Wendy Wang2, Michelle DeGuire2, Kim M. Contardi1, Kathleen W. Gustafson1, and Mark H. Sawyer2. (1) San Diego Immunization Program, County of San Diego Health and Human Services Agency, PO Box 85222, Mail Stop P511B, 3851 Rosecrans Street, San Diego, CA, USA, (2) San Diego Immunization Partnership, University of California, San Diego, 9500 Gilman Drive, MC 0927, La Jolla, CA, USA


BACKGROUND:
HEDIS (Health Plan Employer Data Information Set) is a set of standardized performance measures designed to ensure that purchasers and consumers have the information they need to reliably compare the performance of managed health care plans. The performance measures in HEDIS include both childhood and adult immunization coverage rates. Immunization registries can provide data to health plans for their HEDIS assessments.

OBJECTIVE:
To partner with health plans by providing immunization data for HEDIS assessments.

METHOD:
The San Diego Regional Immunization Registry (SDIR) provided immunization data to 6 health plans in 2003-04 to facilitate their HEDIS data collection. Health plans submitted lists of 43 to 10,670 patients per plan ranging in age from 0-13 years. Staff searched the SDIR database to identify matching patients and provided the associated immunization data back to the health plans for their HEDIS audit process.

RESULT:
SDIR contained immunization data on 1-1068 patients per plan representing 2.3-58.3% of the patients submitted. The greatest percentage of patients (58.3%) with available immunization data was identified for a regional health plan and the fewest (2.3%) were identified for a statewide plan that submitted a very large number of patients that included patients not living in the SDIR region.

CONCLUSION:
Immunization registries can be useful in health plan HEDIS immunization data collection. Searches for patients that are restricted to those living in the registry region will maximize the return of useful data. The availability of significant numbers of patients with immunization data in a registry streamlines the health plan's effort to complete annual HEDIS measures.

LEARNING OBJECTIVES:
To describe the collaboration between the SDIR and several local and statewide health plans to determine plan immunization coverage rates

[ Recorded presentation ]   Recorded presentation

See more of Successful Collaborations with Registry Partners — Part 2
See more of The 2004 Immunization Registry Conference