MassHealth Quality Program Chart Review Support

Organizations that provide services through the MassHealth Community Partners Program may be requested to participate in a periodic chart review process to validate reported Quality Program measures. The core objective of the MassHealth chart review process is focused around the MassHealth Accountable Care Organization (ACO) Quality Payment Program Measures which consists of eight performance measures. Currently, six are standard HEDIS measures and two are custom MassHealth measures that follow a similar approach but are specific to the Community Partners (CP) Program requirements.

Ninestone is available to support your chart review project. The approach that Ninestone uses for these projects incorporates the following components: 

  • Project management
  • Chart Access and Review
  • Data Capture/Storage/Results

Project Management

Based on our standard delivery framework of methods, tools, architectures, and metrics, our chart review offering enables us to provide you with support for your specific needs, including the ability to get up and running with minimal disruption of existing operations, as well as providing the ability to deliver solutions reliably, quickly, and collaboratively with reduced risks and lower costs.

During the project we will provide ongoing management and oversight using an agreed upon set of project management tools to ensure the project remains on time and on budget.

Chart Access and Review

The initial effort focuses on either securing chart access at your participating provider organizations or coordinating with them to secure chart abstracts. Concurrently, we coordinate with your team to review the quality program measures that MassHealth has selected to ensure alignment for the chart review process.

Our team will develop the appropriate validation strategy for each measure and will review it with your team to gain alignment before executing the chart reviews. These strategies will be used as requirements for building out the chart review tracking solution.

We capture the required data for the chart review, calculate measurement validation results, and report findings to chart deficiencies relating to each measure.

Data Capture/Storage/Results

A repository for storing the data to support the chart review results is required. Depending on your requirements and focusing specifically on the level of security/privacy that is required based on your desired dataset, we can leverage one of several different data solutions for the chart review project. Our goal is to provide a solution that meets data capture, accessibility, reliability, scalability, privacy, and security requirements for your chart review project without incurring heavy fiscal or timeline burdens.

Given our experience, we are prepared to provide your organization with high quality services to ensure that a complete, accurate and timely chart review initiative is accomplished.

Resources

TA Marketplace Vendor Page: Visit the Ninestone page on the TA Marketplace website.

TA Application: Remember to request Ninestone as your preferred vendor when completing your TA Application for project requests.

TA Marketplace: Visit the TA Marketplace for complete details.

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