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Medicare
Quality Improvement
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Medicare
Quality Improvement
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MEDICARE
QUALITY IMPROVEMENT
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HSAG's quality improvement organization (QIO) contract with the Centers for Medicare & Medicaid Services (CMS) focuses on beneficiary protection, patient safety, and prevention, by working with Medicare beneficiaries—as well as with providers such as hospitals, nursing homes and physician offices—and through partnerships with health associations and government agencies, managed care organizations, and advocacy groups.
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EXTERNAL QUALITY REVIEW
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HSAG is nationally recognized as an external quality review organization (EQRO) that evaluates managed care organizations (MCOs) and prepaid inpatient health plans (PIHPs) as required by the Balanced Budget Act of 1997, and whose quality review services affect more than 13 million Medicaid recipients, approximately 45 percent of the nation's Medicaid population.
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MEDICAL REVIEW SERVICES
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Medical record review is a cornerstone of HSAG services and a core competency of the organization. HSAG performs medical record review for care provided to Medicare beneficiaries, Medicaid recipients, military health system beneficiaries, CMS programs, and self-funded employer groups.
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AUDITS
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HSAG's audit services assure accurate, reliable, and publicly reportable data that can be used by purchasers and consumers to compare managed care organizations (MCOs). HSAG is also a major market leader in providing Pay-for-Performance (P4P) audit services.
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SURVEYS
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HSAG offers a comprehensive array of survey-related activities. HSAG has extensive experience in managing large, complex data sets for national survey initiatives and conducting ongoing analyses and research pertinent to the presentation and publication of program findings and results. In addition, HSAG’s program and data management expertise supports efforts on behalf of the Centers for Medicare & Medicaid Services (CMS) to make publicly reported data available to consumers and others.
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CONSULTATIVE SERVICES
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HSAG provides expert consulting services to health care providers. HSAG assists with electronic medical record implementation, quality performance management, and Pay-for-Performance reporting. Services focus on cost-effective solutions by making optimal use of HIT while improving patient care and giving customers a competitive advantage.
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SPECIAL STUDIES
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HSAG has successfully competed for and has been awarded special studies by the Centers for Medicaid & Medicare Services (CMS) and other entities to conduct quality research and implement quality projects. These special studies have led to local and national level improvements in quality outcomes, organizational performance, and expanded evidence on best practices for health systems.
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