HEDIS Season Wrap-Up: Are You on Track for 5 Stars?

As health plans race toward the finish line of HEDIS season, the pressure is on. Medical records are in, abstractors are working tirelessly, and overreading teams are ensuring accuracy. But the big question remains: Are you on track to meet your quality goals?

Now is the time for a final review—requesting those last records, validating abstracted data, and making sure every measure aligns with your HEDIS and Star Ratings objectives. Many plans are realizing that next year ‘s results need to look different (which is this year):

More in-year care model initiatives to stay ahead of data and care gaps
Better record acquisition strategies to reduce retrieval headaches
Concurrent auditing to prevent end-of-season surprises
Advanced predictive modeling to forecast and drive outcomes
A new partner or insourced platform to optimize efficiency and impact

At HLTHWorks, we’ve redesigned HEDIS processes and created efficiencies for over 80 health plans. Our approach helps plans run more in-year programs, improve workflow efficiency, and achieve higher Star Ratings—getting closer to 4.5 and 5 Stars with each cycle.

Is your plan ready to level up? Contact us today, and let’s get you to the quality scores you’re targeting!