Best Practice

Quality assurance and HEDIS^®

AllWays Health Partners’ behavioral health partner Optum provides a quality assurance (QA) toolkit for primary care providers (PCPs). This toolkit was designed to explain the substance use disorders and depression measures of HEDIS® to PCPs and give recommendations for meeting these measures. HEDIS stands for Healthcare Effectiveness Data and Information Set, describing a set of performance measures for both behavioral and physical health conditions. The intent is for purchasers and consumers to use HEDIS to compare and evaluate health plans easily.  Not only that, HEDIS sets a standard for the quality of care that patients should be receiving. The National Committee for Quality Assurance (NCQA) uses HEDIS to evaluate PCPs, health plans, and Managed Behavioral Healthcare Organizations.

Our fall/winter member newsletter is in the mail, and fully insured, commercial members should be receiving it soon. This issue includes a guide to preventive care to help members stay well and understand what's covered by their plan. 

October 10 is World Mental Health Day. This year's focus is suicide prevention. Worldwide, suicide is the cause of 800,000 deaths annually. 

World Mental Health Day is organized by the World Federation for Mental Health. This year’s Day is supported by WHO, the International Association for Suicide Prevention, and United for Global Mental Health.

Depression is the leading cause of disability in the U.S. for ages 15 to 44.3. The impact of depression on physical health can include chronic pain, increased risk of heart disease, exacerbation of chronic conditions, and insomnia.  

Primary care providers (PCPs) are often the first to recognize the signs of depression. In order to confirm or rule out a diagnosis, PCPs should use the PHQ-9 screening tool. For more information regarding the PHQ-9 and to obtain the screening tool in additional languages, please refer to PHQ screener website.

Our latest newsletter includes an insider's guide to AllWays Health Partners.