1{z>Y^1(|@jF{iPu~tPmu]1fGdBg8T]\;j/y=d[cug.HPVOIFf?,e?~Z.IieF;&QU;L.ltC9=Ah&Bo*Xn;al}tZF M&3#n$eu-}^ LeofhpaA^3[o%d%aGfif~qUV(b|*+l'62[4Od!$|y6q*l;n V$QhTT/L3T{:]3bc+kG.J~}!r:WNY'~#&zLAo!b[!n}gRWvFE;uq\ct_'[NM~I yO=+ePxku^;{& h:t: pLW\{I\p-%iv) SA, 4w5%J*0$Ja!q_p=gDvqWA:O ON$v@x2Hj. hXmTW3`IBH5@) ZmmP)pZA;H)Tt=lM"VPH`[[Z?j]MTz 51 0 obj <>stream Measures relate to many significant public health issues such as cancer, heart disease, behavioral health and diabetes. 0 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, Healthcare Effectiveness Data and Information Set (HEDIS), CMS contracts with NCQA to collect Healthcare Effectiveness Data and Information Set (HEDIS, Use of Spirometry Testing in the Assessment and Diagnosis of COPD, Pharmacotherapy Management of COPD Exacerbation, Persistence of Beta-Blocker Treatment After a Heart Attack, Osteoporosis Management in Women Who Had a Fracture, Follow-Up After Hospitalization for Mental Illness, Potentially Harmful Drug-Disease Interactions in Older Adults, Use of High-Risk Medications in Older Adults, Transitions of Care (Reporting began in HEDIS MY 2020), Chronic Condition Special Needs Plans (C-SNPs), Dual Eligible Special Needs Plans (D-SNPs), Institutional Special Needs Plans (I-SNPs). Withthisdeprescribing measure, there isan opportunityto promote harm reduction by assessing progress in appropriately reducing benzodiazepine use in the older adult population. ("$e 0)*[sNwL(((((()#(1/I\HlQ3F7n6 e#+}:~9'M]Fn*m(jfe Z)TRPQZWV+9F x_O. HEDIS MY 2022 Measures Applicable to: Commercial Medicaid Medicare Changes for HEDIS MY 2022 General Guidelines for Data Collection and Reporting Np1W>?,Y{ m){w&;9l F*\JR4d87=dkh % Rate 1: Six or more well-child visits* 0 to 15 months. 2 0 obj Copyright 2023 National Committee for Quality Assurance. 0000015971 00000 n startxref NCQAwillconcentrateeffortsontheoutcome-basedHbA1cControlforPatientsWithDiabetesmeasure. 0000011393 00000 n 4 0 obj 0000032016 00000 n Include a goal or benchmark for each measure. The technical specifications for organizations providing Medicaid long-term services and supports (LTSS). You can decide how often to receive updates. 0000008644 00000 n vzp`}jArJ;,-r1cb?>~XVU(pAi-Im kC#)}i^_ eMRNxz;e~FOL:epYMit *9(66a?`4 /[2u0@G5Q^+NDV&h$!~_sO {9oHp3N)I4BP5N1K0Up ]%x2P1xvk?7?]k'a List and define all quantifiable measures used in this activity. t,f`$yF;zXytHo. DL U `j@ +Y&F] S-ppo>8w4Dg`` C 0000068137 00000 n We dont take HEDIS updates and changes lightly: Measure development and updates follow a rigorous process that includes a public comment period and input from advisory panels. lock 0000051029 00000 n Copyright 2023 National Committee for Quality Assurance. 0000004562 00000 n ND-)8^r|\q=.Kx.!J"G8IE o GRs_$ [EN=_sRs 1F/T ? https:// NCQA revised this risk-adjusted outcome measure to exclude planned hospitalizations and updated it to remove separate Medical and Surgical reporting categories, retaining the Total rate (which includes medical and surgical admissions). Intent:Advancecareplanningisassociatedwithimprovedqualityoflife,increasedprovidertrustanddecreasedhospitalization. endstream endobj 33 0 obj <>stream hbbd```b``"gIw ""7|-``qT3l0; fH0DHI@H_mj> _ endobj Terms of Use, Patient-Centered Specialty Practice (PCSP), Credentials Verification Organization (CVO), Managed Behavioral Healthcare Organization (MBHO), Health Information Technology Prevalidation Programs, Virtual Seminars, Webinars and On-demand Training, Advertising and Marketing Your NCQA Status, HEDIS Electronic Clinical Data Systems (ECDS) Reporting, Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC), Appropriate Testing for Pharyngitis (CWP), Use of Spirometry Testing in the Assessment and Diagnosis of COPD (SPR), Pharmacotherapy Management of COPD Exacerbation (PCE), Persistence of Beta-Blocker Treatment After a Heart Attack (PBH), Statin Therapy for Patients With Cardiovascular Disease and Diabetes (SPC, SPD), Kidney Health Evaluation for Patients With Diabetes (KED), Osteoporosis Testing and Management in Older Women (OMW), Antidepressant Medication Management (AMM), Follow-Up Care for Children Prescribed ADHD Medication (ADD), Follow-Up After Hospitalization for Mental Illness (FUH), Follow-Up After Emergency Department Visit for Mental Illness (FUM), Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA), Diabetes and Cardiovascular Disease Screening and Monitoring for People With Schizophrenia or Bipolar Disorder (SSD, SMD, SMC), Adherence to Antipsychotic Medications for Individuals With Schizophrenia (SAA), Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM), Pharmacotherapy for Opioid Use Disorder (POD), Follow-Up After High-Intensity Care for Substance Use Disorder (FUI), Follow-Up After Emergency Department Visit for People With Multiple High-Risk Chronic Conditions (FMC), Non-Recommended Cervical Cancer Screening in Adolescent Females (NCS), Non-Recommended PSA-Based Screening in Older Men (PSA), Appropriate Treatment for Upper Respiratory Infection (URI), Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB), Use of Imaging Studies for Low Back Pain (LBP), Medication Management in Older Adults (DDE, DAE), Use of Opioids from Multiple Providers (UOP), Management of Urinary Incontinence in Older Adults (MUI), Medical Assistance with Smoking and Tobacco Use Cessation (MSC), Pneumococcal Vaccination Status for Older Adults (PNU), Adults Access to Preventive/Ambulatory Health Services (AAP), Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET), Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP), Child and Adolescent Well-Care Visits (W30, WCV), Identification of Alcohol and Other Drug Services (IAD), Hospitalization Following Discharge From a Skilled Nursing Facility (HFS), Hospitalization for Potentially Preventable Complications (HPC), Follow-Up Care for Children Prescribed ADHD Medication (ADD-E), Depression Screening and Follow-Up for Adolescents and Adults (DSF-E), Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults (EMS-E), Depression Remission or Response for Adolescents and Adults (DRR-E), Unhealthy Alcohol Use Screening and Follow-Up (ASF-E), Prenatal Depression Screening and Follow-up (PND-E), Postpartum Depression Screening and Follow-up (PDS-E), Order the HEDIS MY 2023 Digital Measures Bundle, HEDIS MY 2023 Medication List Directory (NDC codes), HEDIS Electronic Clinical Data System (ECDS), HEDIS for the Quality Rating System Value Set Directory, HEDIS for the Quality Rating System Technical Specifications, Technical Specifications Update for the Quality Rating System, Order the HEDS MY 2022 Digital Measures Bundle (includes HEDIS Volume 2), HEDIS MY 2022 Medication List Directory (NDC codes), HEDIS MY 2022 Measure Trending Determinations, MY 2022 Validated Member-Level File Layout, HEDIS MY 2021 Measure Trending Determinations, MY 2021 Validated Member-Level File Layout, HEDIS MY 2020 Volume 2 Technical Specifications Update, NCQA HEDIS Measurement Year (MY) 2020 Requirements and COVID-19, HEDIS MY 2020 Medication List Directory (NDC codes), HEDIS MY 2020 Measure Trending Determinations, MY 2020 Quality Rating System Value Set Directory, MY 2020 Quality Rating System: Technical Update, MY 2020 Volume 3 Technical Specifications Update, Volume 3 MY 2020 Validated Member-Level File Layout, HEDIS Volume 2 & Digital Measures Bundles Comparison, HEDIS 2020 (MY 2019) Vol. } !1AQa"q2#BR$3br 0000010811 00000 n ;(Y}e"XmT8,/l EP5ePVm8,&T2X, +|oM}> O~rEUnM~#jOicJ@2Yus 0000021981 00000 n 0000014293 00000 n Pn MS% 9W4=9Hu-]Sy+G'5} I!Orx*YtK5"Y"}w l_Zqypx -kind&gW%dj56u|x;cIInF7J^u$SqISS:th6 m%64SxllMjD(oh+z Rates for the HEDIS measures were compared to corresponding Medicaid percentiles; comparison results are provided in the tables. For full specifications, visit the NCQA store. HSn0+THK[iF(P=2@oA.kY"cL@YG6u}(K]*-50 j"1J0B(E$akG) endstream endobj 30 0 obj <>stream 1CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). HEDISpublicationsareavailableas electronic publications. ) ,wBInd!d98{9|/.Y1&7wULt~s`GgvXT\/T}[_}bVT=TXk;e*ZkQXH#7hUxQ"zZdP> 74,457 : 61.4% : 61.1% : 61.7% : 55.9% + 60.5% + >= 90th percentile PA . |@Z-Q Share this page with a friend or colleague by Email. Island managed care plans must provide performance measure data, specifically HEDIS, to the Office of Health . 0000011142 00000 n We do not share your information with third parties. 0000018438 00000 n More than 200 million people are enrolled in plans that report HEDIS results. z.XM)Z- b#|UX&)E#T"5Y2]AmiJR Ju:'GVx w9E,*343P@moN$33XN}jl^F-|]}Z{lRt~wOr$.-ks>:599_zrapw)?OqKTa^th>LM _R`]~%Qyqx` 1~ 0000008708 00000 n 0 Heres how you know. ( 0000009251 00000 n Currently, HEDIS consists of 90 different measures across six domains of care: Effectiveness of Care Access/Availability of Care Experience of Care Utilization and Risk Adjusted Utilization Health Plan Descriptive Information Measures Reported Using Electronic Clinical Data Systems We do not share your information with third parties. _hRos0Tx|1Ug% Table 4: PCCP HEDIS Performance Measures - MY 2021 . ?^>&d;ijSl+EPe7"z_?0Kx)uQ 2527 53 Formoreinformation,refertothefullmeasurespecificationsinHEDISMY2022. <> Specifications outline measure definition and details, which outline the specifications required to evaluate the recommended standards of quality for the element(s) in the measure. HTn0*hk!4J[&5i7Y%I yf x Updated Guideline 7: Measurement Period Adjustments. HUG members are health care professionals who produce, report and interpret HEDIS data. 8 0 obj akJ9d&'(o,N|cV& }3~_UEiP TABLE 1: 2022 VBP LIST OF REQUIRED MEASURES - Required to Report NA - Not Applicable to the Arrangement Shading - Purple- Not required to be reported 1 - There are no reporting requirements for this measure. NCQA screens, trains and certifies organizations that collect or audit data for health plans and providers. Intent:Antibiotics prescribed for acute respiratory conditions are a large driver of antibiotic overuse. We dont take HEDIS updates and changes lightly: Measure development and updates follow a rigorous process that includes a public comment period and input from advisory panels. <> }{7wi\vLU#)J1i#} ;?0L1$Zh\D#$M},[Na_MxQ~+EYs}VgeWPL;hhWs, k>^c-sNWAOHKd3:o A list of potential measures for initial stratification in MY2022 are as follows: Controlling High Blood Pressure (CBP) Comprehensive Diabetes Care (CDC) Antidepressant Medication Management (AMM) Follow-Up After Emergency Department Visit for People with Multiple High-Risk Chronic Conditions (FMC) 0000004224 00000 n Summary Table of Measures, Product Lines and Changes 1 HEDIS MY 2022, Volume 2 HEDIS VOLUME 2 MY 2022 . (HEDIS) measures that assess quality of health care provided to Blue Shield Promise Medi-Cal members. To learn more. MY 2002 was the yearfirst that follow-up rates were reported. %PDF-1.6 % VA outpatient measures closely follow the specifications set forth by the National Committee for Quality Assurance (NCQA), Healthcare Effectiveness Data and Information Set (HEDIS). 0000001946 00000 n Copyright 2023 National Committee for Quality Assurance. NCQArevisedthemeasurestructurefromutilizationtodiagnosed-prevalenceofsubstanceuseandupdatedthenameto. Tobacco Cessation Program. 0000019234 00000 n Social Determinants: Our Statement with TJC, NQF Was Just the Start. Quality Compass 2022 includes certain CAHPS data. 6 0 obj The complete MIPS Quality Measures List published after the PFS final rule does not include Qualified Clinical Data Registry (QCDR) measures as such measures are proposed and selected through a separate process. Initiation and Engagement of Substance Use Disorder Treatment; changed the measurefrommember-basedtoepisode-based; changed thedenominatortolengthenthenegativeSUDhistoryperiodfrom60daysto194daysandremoveEDvisitsandmedicallymanagedwithdrawalfromthenegativeSUDhistoryperiod;removed the numerator requirementthatpsychosocialtreatmentaccompanypharmacotherapy; and revisedtheagestratificationstoreflectages1864yearsand65+years. stream ComprehensiveDiabetesCare/HemoglobinA1cControlforPatientsWithDiabetes,EyeExamPerformedforPatientsWithDiabetes,BloodPressureforPatientsWithDiabetes. !(!0*21/*.-4;K@48G9-.BYBGNPTUT3? HSMk@WHM[Zl8 p ccwVrLCV{6GfP!Kh~&)/uY>ak9 Encounter data is crucial for demonstrating accurate quality performance to the Department of Health Care Services (DHCS). Auditsprotect results validity and reliability. 0000010141 00000 n 0000016920 00000 n b~GiQ">sTMj 2p1IcvIwsudr 9 0 obj 5kET"gDka6FT@-hU \N!VGk}J.V29< 4940 0 obj <>/Filter/FlateDecode/ID[]/Index[4920 31]/Info 4919 0 R/Length 102/Prev 502761/Root 4921 0 R/Size 4951/Type/XRef/W[1 3 1]>>stream Save your favorite pages and receive notifications whenever theyre updated. endobj Terms of Use, Patient-Centered Specialty Practice (PCSP), Credentials Verification Organization (CVO), Managed Behavioral Healthcare Organization (MBHO), Health Information Technology Prevalidation Programs, Virtual Seminars, Webinars and On-demand Training, Advertising and Marketing Your NCQA Status, HEDIS Electronic Clinical Data Systems (ECDS) Reporting, HEDIS Medicare Health Outcomes Survey and the Medicare Health Outcomes Survey Modified, NCQA collects HEDIS data from health plans. Share this page with a friend or colleague by Email. NCQAintroducedraceandethnicitystratificationstofiveHEDISmeasures: Colorectal Cancer Screening, Controlling High Blood Pressure, Hemoglobin A1c Control for Patients with Diabetes, Prenatal and Postpartum Care, and Child and Adolescent Well Care Visits, NCQAplanstoexpandtheraceandethnicitystratificationstoadditionalHEDISmeasuresoverseveralyearstohelp, disparitiesincareamongpatientpopulations. QLeRQ~{?$u>%)G7,]m?oaS`AD>O)>fC*b9Zj #b&=c;m4lYVy7&>c)|5+Z7Sw 3tUfQ|x]zZ>!B2P10d@9>UE*EE$6PZtegv:(J5#,ojt1mGL+9AYdeQ4ec`"omT2%^(_&/>~8_+7F]e*}1b>(Q}\4t0 0000047520 00000 n 0000005676 00000 n Rate 2: Two additional well-child visits 15 to 30 months. ThenewestadditionstoHEDISaddresspatient-centered care, as well assafetyand appropriateness. 0000002321 00000 n 2023 HEDIS Measures HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). Data from the 2020 measurement period (2022 Star Ratings) help us understand how the PHE impacted the care delivery system. %%EOF 0000010320 00000 n ThiseffortbuildsonNCQAsexistingworkdedicatedtotheadvancinghealthequityindataandqualitymeasurement. endobj Utilization and Risk Adjusted Utilization. HEDIS Measure - Term for how each domain of care is further broken down. HEDIS Tip Sheet - Pediatric Measures -Look back period: July 1 of the year prior to June 30 of the measurement year. !9g=SW[h ,3%`~,Z-"3b~lv?.cKQZLHJ*??Y$t)mvdQZt6F^_"g&Oa}t%&QZ./w|PCZE9vG2{m!miVv| Q@?\ti+3#{lgi Sign up to get the latest information about your choice of CMS topics. endstream endobj startxref 0000002938 00000 n Accountable health care requires both measurement and transparency. . To be able to identify andreduce disparitiesin care, the first step must be measuring and reportingon. D('@E$xVK`"P6 ?L dvC) ? 0000020276 00000 n 65 years of age and older who were dispensed benzodiazepines and achieved a 20% decrease or greater in benzodiazepine dose during the measurement year. %%EOF The Healthcare Effectiveness Data and Information Set (HEDIS) is one of health cares most widely used performance improvement tools. hb```f``2g`a`ad@ Arl`h\=g}8,{GzGKEGCE\ p10:ki> la HEDIS quality measures for Accountable Care Organizations. click here for a discussion of this new measure. C*@ep!%E#-nb4LM \\R4G_$g$T!7(9 Save your favorite pages and receive notifications whenever theyre updated. HEDIS MY2022. 0000009893 00000 n Experience of Care. 0000004692 00000 n endstream endobj 32 0 obj <>stream 3 0 obj Trackingantibioticprescribingforallacute respiratory conditionswillprovide context about a healthplansoverall antibiotic use when viewedwiththree HEDIS measures ofappropriatetesting and inappropriate prescribing for upper respiratory infections, pharyngitis and acute bronchitis. New digital measures reduce the burden of reporting quality results. %PDF-1.7 % 0000018052 00000 n %%EOF xKK@ { a;;:/DCXlcf_YB^Q(przeq0)# 0y,-h6-2Y=Vf]+[eq[&ge1heucd;)CzGE"z&D%z`SS?I1ZOFb ?=xb =WV!Nfvb)e:R '$t^OWoM9o{$)GlCeSkftDJbR2$n{Y4O}0m$&pmT|yQ;x/8Z$[G@MY?mcwo;oN:p2 Follow-UpAfterEmergencyVisitDepartmentVisitforAlcoholandOtherDrugDependence/Follow-UpAfterEDVisitforSubstanceAbuse. 7 0 obj stream 0000050943 00000 n !nGK3(@kt !1}wJ5|?7lm^[/ e|_ zLIUQKO5E*;'rc2@wN2| 2e^ w7] x-7q^5(Ms-NYkelK*:gY\5V[l.Anr|XeNBe,KxGnrtmL{_-ApmCw2+E2TA@GhQWyteWLLvpaPeH5XR Height, weight, BMI percentile (use Z68.51-Z68.54) and nutrition (97802, 97803, 97804) and physical activity counseling (Z02.5, Z71.82) Lead Screening in Children: CJ)8kPqQy!h\ADICp%F$NhG-EL'nU%mQ*1HPl. 0000009572 00000 n !3$Y:wn=3. cytology performed between 2020-2022. endstream endobj startxref Share this page with a friend or colleague by Email. 4920 0 obj <> endobj CPT: 87070, 87071, 87081, 87430, 87650-87652, 87880 HEDIS Tip Sheet - Pediatric Measures Key HEDIS Factors to Consider 0000003808 00000 n Two rates are reported. NCQA defines how data can be collected for a measure: Anticipated Release Date: July 2023. Advancecareplanningisassociatedwithimprovedqualityoflife,increasedprovidertrustanddecreasedhospitalization. 0000004219 00000 n UseofImagingStudiesforLowBackPain. <> rFZ /CvN`(,b$CoyeL`Y6P-@ SNPs reported the following measures in HEDIS 2016: Colorectal Cancer Screening Care for Older Adults Use of Spirometry Testing in the Assessment and Diagnosis of COPD Pharmacotherapy Management of COPD Exacerbation Controlling High Blood Pressure Persistence of Beta-Blocker Treatment After a Heart Attack 2022 MEDICAID HEDIS REFERENCE SHEET FOR PROVIDERS 3 PEDIATRIC HEDIS MEASURES HEDIS MEASURE AGE MEASURE DESCRIPTION BILLING CODES WELL-VISIT Well Child Visits 0-30 Months of Life (W30) 0-30 months Telehealth exclusion removed. h^3VN,vAO]{Q@v gK2CxD]*{Dv= Px k7j^AEE]iQcWA/]?N8MhIB HA]2kNHAE Vc"c)\v1s9]OA2mJ)$'8 gbv[Dp[,tkg`h`PR``46R @0ft@ ublH$`@K WH@uX^$28C23n`Rbts&H-dpo]n0ch K$l7@ LD%@H00r'UvU h# 9745 0 obj <> endobj xref For HEDIS measures that report age cohorts beyond 19 years old, rates reported below only extend to 19 years old to align with CHIP enrollment and are noted as such. R'A@>r 5^[qLp.p*DB24V,mb66vA8kwFvM@gf` r The Rules for Allowable Adjustments are included in the HEDIS Volume 2 publication after the applicable HEDIS measure specifications. Visitors to this page often check HEDIS FAQs, QRS FAQs, or ask a question through MyNCQA. ]c\RbKSTQ C''Q6.6QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ T " IdentificationofAlcoholandOtherDrugServices/DiagnosedSubstanceUseDisorders. CMS contracts with NCQA to collect Healthcare Effectiveness Data and Information Set (HEDIS) measures from Medicare Special Need Plans (SNPs). AntibioticUtilizationforRespiratoryConditions. Avoidance of Antibiotic Use. endobj Women 30-64 years of age who had cervical high-risk human papillomavirus (hrHPV) 0000008747 00000 n endstream 0000002169 00000 n The percentage of episodes for members 3 months of age and older with a diagnosis of a respiratory condition that resulted in an antibiotic dispensing event. Quality Compass 2023 Medicaid-Trended Data (MY 2022, MY 2021) with Data Exporter. HEDIS survey measures and standardized surveys from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) program. Laboratory Benefit Management. the HEDIS Measurement Year (MY) 2020 & 2021 Volume 2 Technical Speciications. .gov HEDIS nonsurvey measures for organizations; instructions on data collection for each measure; general guidelines for calculations and sampling. 0000010486 00000 n hbbd``b`$ $$zAm b1["A)@"|)k$@@Bv5#JQ' [@ Intent:The 2019 American Geriatrics Society Beers Criteria recommendthat benzodiazepinesbeavoidedinolderadults. 0000044978 00000 n <> 0000035489 00000 n High-qualityhealthcaremustbeequitablehealthcare. 0000007305 00000 n How are rates calculated? NCQAexpandedtheupperagelimitfrom50to75;addedreportingfortheMedicareproductline;addedfourclinicalexclusionsforosteoporosis. The Inventory lists each measure by program, reporting measure specifications including, but not limited to, numerator, denominator, exclusion criteria, Meaningful Measures domain, measure type, and National Quality Forum (NQF) endorsement status. Plans must purchase the HEDIS 2022 Technical Specifications for Health Plans for specifications of the required HEDIS measures. NCQAnowcollectsthenewAntibioticsforRespiratoryConditionsmeasure.
