Quality Reporting for Medicare Advantage
This presentation is an overview of the Healthcare Effectiveness Data and Information Set (HEDIS) and the Five-Star Quality Rating System. This presentation will discuss how documentation and coding play roles in quality programs and will review the required documentation and coding criteria for selected measures to close the gap in quality reporting.
This activity is jointly provided by OptumHealth Education and Optum Risk, Quality & Network Solutions.
There was no commercial support received for this activity.
This activity is designed to meet the educational needs of coders and physicians that have an interest in learning about the importance of accurate coding and documentation.
At the end of this educational activity, participants should be able to:
- Describe the HEDIS and the CMS Star Ratings.
- Recognize the importance of documentation and coding in quality programs.
- Identify the required documentation and coding criteria for selected measures to close the gap in quality reporting.
Sarah Chart, RN
Rebecca Gleason, RN, CCM
Crystal Wong, MD
Propoint Medical Writing
David S. Brigner, MLAS, CPC, CPC-I
|Amber Green, DNP|
National Vice President of Training, Provider Engagement & Strategy
Optum Risk, Quality & Network Solutions
Christine Kenny, PhD, DNP, GNP/ANP-BC
|Carrie Mann, MBA, CPC, CPC-I|
National Director of Training, Provider Engagement & Strategy
Optum Risk, Quality & Network Solutions
Kate Tierney, CPC, CPC-P, CPMA, CRC, CPC-I, CEDC, CEMC, CGSC, COBGC
Michelle Tulier, CPC, CDEO, CPMA, CRC, CPC-I
Disclosures of relevant financial relationships
In accordance with the ACCME Standards for Commercial SupportSM, OptumHealth Education (OHE) requires all those involved in the development of activity content to disclose their relevant financial relationships. An individual has a relevant financial relationship if such person (or his/her spouse/partner) has a financial relationship in any amount occurring in the last 12 months with a commercial interest. OHE ensures that the content is independent of commercial bias.
Ms. Chart and Ms. Gleason have indicated that they are employees of and own stock in UnitedHealth Group.
The remaining activity faculty or planners have no financial relationships to disclose.
In support of improving patient care, this activity has been planned and implemented by OptumHealth Education and Optum Risk, Quality & Network Solutions. OptumHealth Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE) and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Credit designation statements
OptumHealth Education designates this live activity for a maximum of .5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The American Academy of Physician Assistants (AAPA) accepts credit from organizations accredited by the ACCME.
The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts credit from organizations accredited by the ACCME and ANCC.
AAPC will honor 1-for-1 CEUs for any live event offering CME credit or AMA PRA Category 1 Credit™. A certificate of attendance or completion is necessary to show participation. The certificate will give the total CMEs possible for the offering. Physicians are advised to claim only the actual hours that they were present during the education. We ask that AAPC-certified members abide by this request also. One hour of instruction is worth 1 CEU.
A certificate of attendance will be provided to learners upon completion of activity requirements, enabling participants to register with licensing boards or associations that have not been pre-approved for credits. To apply for credit types not listed above, participants should use the procedure established by the specific organization with which they wish to obtain credit.
- 0.50 AAPC
- 0.50 AMA
- 0.50 Attendance