Helping a Small but Mighty Team Succeed With Quality Reporting

Health Services for Children with Special Needs (HSCSN), a specialized Medicaid health plan in Washington, D.C., serves one of the nation’s most vulnerable populations — children and young adults with special needs. With a small quality and data team, many of whom were new to HEDIS®, HSCSN needed a partner who could help them collect and manage quality data efficiently and confidently.

Inovalon’s Electronic Record On Demand^TM delivered the expertise and infrastructure they were missing, and helped them lay the foundation for long-term success. Using Inovalon’s software, HSCSN gained a smoother audit process, greater visibility into performance, and stronger readiness for the future.

HSCSN serves children and young adults (ages 0–26), all of whom have qualifying diagnoses under the Supplemental Security Income (SSI) program. Focused exclusively on this population, HSCSN’s approach is specialized and personalized, and their resources must be, too.

With a small quality team and limited internal infrastructure for capturing electronic clinical data, HSCSN sought tools and support to improve outcomes and meet evolving regulatory benchmarks.

HSCSN’s quality team, including Director of Quality Analytics & Process Improvement, Lindsay Dafir, faced two major challenges:

1. Limited internal resources: The small team lacked the bandwidth and technical infrastructure to efficiently collect and report clinical data.
2. HEDIS inexperience: Many team members, including Lindsay herself, were newly tasked with HEDIS responsibilities and needed a partner who could guide them through the complexities of reporting, audits, and electronic data retrieval.

Despite trying to capture Electronic Clinical Data Systems (ECDS) measures internally for over a year, the team lacked the systems they needed to do it effectively. And with auditors recommending improvements in this area, HSCSN needed a reliable solution.

Having worked with Inovalon as their HEDIS vendor, HSCSN already had a trusted relationship in place. When it came time to expand into electronic record retrieval, the decision was easy. “It just didn’t feel right going with anyone else,” Lindsay shared. “You have everything all together, you’re our HEDIS vendor, you do the submission, we have our weekly meetings. We figured if anyone could do this and do it well, it would be you.”

Despite implementing Electronic Record On Demand late in the HEDIS season — just weeks before the data submission window closed — Inovalon’s team moved quickly. “I’m honestly amazed that your team was able to do it so quickly” said Lindsay. “I think we implemented in a month. I don’t think anyone else could have done it.”

The implementation of Electronic Record On Demand, alongside Inovalon’s Converged Quality^TM, established the critical foundation for future success.

With more time to plan this year, HSCSN is excited to use Inovalon’s quality tools to collect records earlier and more frequently. “I’m excited to be able to use Electronic Record On Demand more fully and see what benefits we can get from it… I think it will impact our rates earlier so that we can better devote resources to where they’re needed.”

Above all, Lindsay credits Inovalon’s team, and their client-first approach, for helping HSCSN navigate a complex and unfamiliar landscape. “I have been so happy partnering with Inovalon… after working with Inovalon I realized there is no alternative.”