iCare Health Solutions, LLC (iCare) has announced that its Diabetic Retinal Exam (DRE) patient outreach program has helped five of its Florida-based Medicare Advantage partners earn the CMS Five-Star rating for their Healthcare Effectiveness Data and Information Set (HEDIS) Diabetic Retinal Exam (DRE) measure for a second consecutive year. “We are extremely proud to announce this achievement, “ says Lee Stern, CEO of iCare Holding’s Inc. “There are many obstacles to overcome to achieve a five-star rating for the DRE measurement. Our HEDIS team surmounted geographical, socioeconomic, and communication barriers to reach targeted plan members throughout Florida. For five health plans to achieve the five-star rating is rare and achieving this accomplishment two years in a row is unheard of and unique to iCare. I commend iCare’s HEDIS team and its leaders for their amazing work.”
iCare works with its HEDIS contracted health plan partners by targeting members who are non-compliant for their diabetic retinal exam. iCare offers dilated exams through its network of eye care providers or provides non-dilated screenings conducted by iCare technicians at the member’s primary care physician’s office, clinics, health fairs, health plan partner events, or the member’s residence. “Providing non-compliant health plan members with choices is fundamental to the success of the program, states Tamara Bruns, Executive Vice President of Care Delivery Transformation at iCare. “Non-compliant health plan members may not receive diabetic retinal screenings for several reasons. Some members lack transportation or are unable to drive; others may not know that having diabetes puts them at risk for vision loss or may be reluctant to receive a dilated eye exam. We strategically design our HEDIS program to address these barriers to care.”
According to the Centers for Disease Control and Prevention (CDC) National Diabetes Statistics Report, 2020, diabetes affects more than 34 million Americans. The CDC estimates 4.1 million and 899,000 Americans are affected by retinopathy and vision-threatening retinopathy, respectively.
“Diabetic retinopathy progressively damages the retina, which is why early detection and treatment can prevent vision loss,” adds Bruns. ”For this reason, DREs are an essential part of diabetic care. Our DRE patient outreach program is one of the most impactful ways we can improve health outcomes for our health plan partners’ members.”
iCare’s contracted HEDIS health plan partners benefiting from iCare’s customized outreach DRE solutions include Coventry, Humana, United Healthcare’s Medica Healthcare, and others.
HEDIS is a tool used by more than 90 percent of America’s health plans to measure performance based on critical dimensions of care and service, including how many of their members receive preventive health screenings. Health plans offering Medicare and Medicaid services must identify members who are out of compliance and encourage them to undergo testing, follow up, and treatment.
iCare Health Solutions is a managed ocular health organization that contracts with health plans and multi-specialty clinics. iCare delivers comprehensive ocular solutions through its state-wide network of optometrists and ophthalmologists. For almost 40 years, the company has met the challenges of the ever-changing health care landscape to transform the way ocular health care is delivered to help more people see better, feel better, and live healthier lives.