Accreditations/Certifications

Quality Improvement Organization—Arizona

Since 1979, HSAG has served to improve the health care quality of Arizona Medicare beneficiaries. As the Arizona quality improvement organization (QIO), HSAG collaborates with hospitals, nursing homes, and physician offices, and partners with health and government agencies, managed care organizations, and advocacy groups to achieve "the right care for every person every time." As the Arizona QIO, HSAG works with providers throughout the state, seeking to influence the health care system and the care that is delivered so it can be made safe, effective, timely, patient-centered, efficient, and equitable by examining processes of care and assisting in process improvement. Over the next three years (2008–2011), HSAG will center its quality improvement initiatives on beneficiary protection, patient safety and prevention.

Quality Improvement Organization—California

HSAG is California's newly contracted Medicare quality improvement organization (QIO). As the California QIO, HSAG works to improve health care for Medicare beneficiaries through collaboration with providers in hospitals, nursing homes, and physician offices, and through partnerships with health and government agencies, managed care organizations, and advocacy groups. As the California QIO, HSAG works with providers throughout the state to achieve "the right care for every person every time," seeking to influence the health care system and the care that is delivered so it can be made safe, effective, timely, patient-centered, efficient, and equitable by examining processes of care and assisting in process improvement. Over the next three years (2008–2011), HSAG will center its quality improvement activities on beneficiary protection, patient safety, and prevention.

External Quality Review Organization (EQRO)

HSAG has more than 25 years of experience performing external quality review (EQR) activities. While officially designated as an EQRO for 12 states, HSAG provides EQR-like services in 14 states. HSAG began performing EQR activities in 1983 for the Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid program, and currently provides services in Arizona, Arkansas, California, Colorado, Florida, Georgia, Hawaii, Illinois, Michigan, Nevada, Ohio, Tennessee, Vermont, and Washington. HSAG works collaboratively with the state Medicaid agencies for which it performs EQR services to help improve the quality of care provided to Medicaid recipients. This effort involves interfacing with state Medicaid agencies and managed care plans to validate performance measures, review performance improvement projects, and assure contract compliance. In addition, HSAG performs encounter data validations and consumer and provider surveys. Moreover, HSAG collaborates with each state's staff to develop the state quality improvement plans and to design initiatives that will result in measurable outcomes. All told, HSAG's work affects more than 13 million Medicaid recipients, approximately 45 percent of the nation’s Medicaid population.

NCQA-Licensed HEDIS^® Compliance Audit™ Organization

As an NCQA-Licensed HEDIS® Compliance Audit™ Organization (LO) since 1998, HSAG has developed expertise in conducting the NCQA audit process for a variety of managed care organizations (MCOs), prepaid inpatient health plans (PIHPs), and other health care delivery systems. HSAG has eight NCQA-Certified HEDIS Compliance Auditors (CHCAs) on staff. No other organization has this many full-time CHCAs. It is important to note that much of HSAG's experience is in auditing the Medicaid product line. HSAG has conducted over 300 HEDIS compliance audits for MCOs nationwide since 1999, allowing us to positively impact more than 3 million lives. HSAG is also a major market leader in providing Pay-for-Performance (P4P) audit services, conducting more than 200 P4P audits since 2003.

NCQA-Certified CAHPS Survey Vendor

HSAG has been an NCQA-Certified CAHPS® Survey Vendor since the inception of the NCQA program in 1999, and conducts surveys in accordance with the CMS Protocol for Administering or Validating Surveys. HSAG is thoroughly familiar with all eight specified activities that must be undertaken to ensure methodologically sound surveys. HSAG possesses a wealth of CAHPS survey knowledge, due to its experience in performing CAHPS surveys and other survey-related activities for state Medicaid agencies, in Colorado, Florida, Hawaii, Michigan, Nevada, Ohio, Oregon, Tennessee, and Washington.

URAC-Accredited for Health Utilization Management

Since 1993, HSAG has been fully accredited to perform health utilization management by URAC, an independent, nonprofit organization that is well known as the leader in promoting health care quality through its accreditation and certification programs. Case review has been a cornerstone of HSAG services for more than 20 years and is a core competency of the company. HSAG provides a variety of case review activities including utilization management, quality review, independent external peer review, case management, and benefits review.

GSA Contract Holder

HSAG is qualified by the U.S. General Service Administration (GSA) for Mission Oriented Business Integrated Services (MOBIS) projects. HSAG is approved to offer consulting, facilitation, data analysis, and survey services, as well as program integration and project management for U.S. government agencies and departments that purchase from the GSA Schedules. (MOBIS – GS-10F-0166R).