Millennium Working to Streamline DY3 Record Review Collections
Medical Record Review Update
By Priti Bangia, Population Health Manager
Millennium extends thanks to our partners for all the help with the Delivery Service Reform Incentive Program (DSRIP) Medical Record Review abstraction process that ended January 2017.
In August 2016, The New York Department of Health (DOH) partnered with the Medical Record Review abstraction firm, Verisk Health http://www.verisk.com/, to conduct Medical Record collection and abstractions for all Performing Provider Systems participating in DSRIP. All partners selected for record reviews received a letter from the DOH Medicaid Redesign Team with instructions for submitting records for a sample of Medicaid members.
The DSRIP Medical Record Review process was different from the Medical Record Reviews conducted by Health Plans and may have generated some confusion for Millennium Partners. Millennium worked closely with the Record Review vendor, Verisk, to ensure that reviewers could connect with the appropriate person at the site of review (hospital or practice location).
Practices were selected through a randomized sampling methodology to collect patient medical records and abstract charts to populate six Healthcare Effectiveness Data and Information Set (HEDIS) measures:
- Controlling high blood pressure (CBP)
- Prenatal and postpartum care (PPC)
- Frequency of ongoing prenatal care (FPC)
- Childhood immunization status (CIS)
- Lead screening in children (LSC)
- New York specific measure – Screening for clinical depression and follow up (SCD).
These medical record reviews are used to:
- Augment claims data – such as Blood Pressure values at a clinic visit in the case of the CBP measure.
- Verify best practices – practices such as the ability to conduct a Patient Health Questionnaire-2 (PHQ-2) or 9 depression screen and capture that information within the electronic medical record (EMR), (in the case of the SCD measure).
As we move into DSRIP Year 3, we look forward to working with our partners to streamline record review collections as DSRIP measures morph from Pay-for-Reporting (DSRIP funds received from DOH for Reporting data) to Pay-for-Performance’ (DSRIP funds received for meeting DOH targets). Our DSRIP Year 5 April 2020 targets are listed in the table below.