Use HEDIS® Guidelines to Help Keep Older Adults Healthy

Healthy SeniorsEncourage your patients to be proactive in addressing mental health issues to improve their quality of life and decrease related negative health outcomes.

The Healthcare Effectiveness Data and Information Set (HEDIS®) is a tool used by more than 90 percent of America's health plans to measure performance on important dimensions of care and service. Health insurers must consider HEDIS® Measures to maintain the integrity of their services and are compared and evaluated based on their scores.

Providers can use these measures as a framework to improve Care for Older Adults (COA), including:

  • Medication Review
  • Function Status Assessment
  • Pain Assessment

Reach out to your older patients, prior to their scheduled routine annual physical exam to:

  • Assess their functional status
  • Ask them about whether they are experiencing any pain (Pain Level Screening)
  • Obtain a list of current medications.

Collect pre-appointment data via:

  • Mail
  • Phone interview by a case manager
  • Online (instructions can be provided when the patient calls to make the appointment)

Providers who use these HEDIS® measures accomplish the following:

  • Improved patient care: clinicians obtain an integrated, holistic and clinically objective view of their patient
  • Optimal use of visit
  • Satisfaction of three HEDIS® quality measures, including Functional Status, Pain Level Screening and Medication list. See explanations below:

1.   Functional Status:

The Functional Status Questionnaire (FSQ) includes three questions from the Basic Activities of Daily Living (ADL) screening, including:

  1. During the past months, have you had difficulty taking care of yourself; that is, eating, dressing, or bathing?
  2. During the past month have you had difficulty moving in and out of a bed or chair?
  3. During the past month have you had difficulty walking indoors, such as around your home?

Responses: usually did with no difficulty (4), usually did with some difficulty (3), usually did with much difficulty (2), usually did not, because of health (1), usually did not, due to other reasons (0).

Lower scores indicate functional impairment in one or more of the domains and require further evaluation.

2.  Pain Level Screening:

As a physician, you know that pain impacts quality of life. The four pain screening questions from the Vanderbilt University Medical Center for Quality Aging assessment tool help to assess the patient’s level of pain. They are:

  1. Do you have anywhere pain right now?
  2. Does pain ever keep you from sleeping at night?
  3. Does pain ever keep you from participating in activities or doing things you enjoy?
  4. Do you have pain every day?

Chronic pain is present if the patient answers “Yes” to questions 1, 2, 3 or to question 4 alone. These patients require further evaluation and appropriate treatment.

3.  List of Current Medications:

Check with your patient and their file about current medications they take. Remember to ask if there are medications prescribed by other doctors and include these as well. Assemble a complete list of medications. Discuss each with your patent during their next office visit.

Document the results of any screenings. Get credit for the work you've done! Pre-collection of this patient information is a valuable tool that meets the needs of your patient, while also satisfying HEDIS® measures.

HEDIS® is a registered trademark of the National Committee for Quality Assurance.

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