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Letter from Dr. Whibbs regarding HEDIS measures

November 1, 2007

Dear Health First Network Physician Colleague:

Attached to this memo is a current list of the HEDIS measures pertinent to our WellCare and HealthEase members. This is the first complete and up-to-date list received from the Health Plan of those measures that we, as practicing physicians, are evaluated on. These preventive care services are specific to different age groups, and the attached list includes valuable information on the specific service, the standard that must be met, and the applicable CPT and ICD-9 Diagnosis and Procedure codes that must be used to capture the data. For WellCare and HealthEase members, these apply to services that must be completed by December 31, 2007.

WellCare/HealthEase evaluates the performance of our entire Network and of individual physicians by a percentage score that indicates compliance with the completion of these measures on our patients. WellCare is requesting our assistance to achieve a score of 75% or better on each of the measures by December 31, 2007.

On certain measures, WellCare has informed us that Health First Network, as one of their highest performance Physician Networks, has already achieved a score of 75% or better. On other measures, we are below state averages. Concern was expressed over the lower than average scores for Diabetic Eye Exams and Glaucoma screenings.

I'm asking your help to work with me in the upcoming weeks to improve our scores on certain measures; to ensure that your office staff are using the correct codes for billing, and to respond to requests from our Nurse Case Managers for clinical information on some WellCare and HealthEase members. This will allow us to completely and accurately provide data required by the state and federal government to the Health Plan.

Thank you for your assistance.

Sincerely,

William J. Whibbs, M.D.
Medical Director

http://www.hfni.com/providers/hedis.pdf


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