QI 1 and QI 2 utilize the HEDIS methodology for this measure. II. 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. CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). 0000004794 00000 n **For Complaints about the Plan 0000032016 00000 n <> m="=jVvyNc{ For example, 2022 claims, encounters, and other HEDIS data are submitted throughout 2022. HEDISpublicationsareavailableas electronic publications. 0000010840 00000 n Thismeasurewillallowplanstounderstandifadvancecareplanningisprovidedtobeneficiarieswhoaremostlikelytobenefitfromit. 1358 0 obj <>stream Anticipated Release Date: July 2023. endobj 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. AdvanceCarePlanningIndicator. hXmTW3`IBH5@) ZmmP)pZA;H)Tt=lM"VPH`[[Z?j]MTz Quality Compass 2022 includes certain CAHPS data. NCQAseparatedtheindicatorsintothreestandalonemeasures:HemoglobinA1cControlforPatientsWithDiabeteswith indictors for HbA1c Control <8 and Poor Control HbA1c >9,EyeExamPerformedforPatientsWithDiabetes,BloodPressureControlforPatientsWithDiabetes. As low as $16,810.25. _hRos0Tx|1Ug% HUG members are health care professionals who produce, report and interpret HEDIS data. andaddedtwocross-cuttingexclusions:palliativecareandadvancedillness/frailty. HEDIS digital future has begun. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S>> stream C*@ep!%E#-nb4LM In January to May of 2023, data for 2022 continues to be submitted along with Medical Record review for Hybrid measures and final HEDIS 2022 rates and results are reported. xPX]NG&)R.ng} (1$JMYpwV:] t,f`$yF;zXytHo. 0000008747 00000 n The Healthcare Effectiveness Data and Information Set (HEDIS) is one of health cares most widely used performance improvement tools. Utilization and Risk Adjusted Utilization. 1067 0 obj <> endobj This manual describes in detail only the NYS-specific measures. Other changes assure that HEDIS will be useful, valid and reliable for a new era of medicine. Toorder,call888-275-7585orvisittheNCQAPublicationswebsite. vzp`}jArJ;,-r1cb?>~XVU(pAi-Im kC#)}i^_ eMRNxz;e~FOL:epYMit *9(66a?`4 /[2u0@G5Q^+NDV&h$!~_sO {9oHp3N)I4BP5N1K0Up ]%x2P1xvk?7?]k'a performance reported in the 2022 Quality Compass (measurement year 2021) . DeprescribingofBenzodiazepinesinOlderAdults. Measures Reported Using Electronic Clinical Data Systems HEDIS Medicare Health Outcomes Survey 4920 0 obj <> endobj 0000036100 00000 n 0000010486 00000 n 0000009457 00000 n HEDIS Measures for Diabetes are assessed to evaluate the effectiveness of the program. 0000000016 00000 n endobj Auditsprotect results validity and reliability. 2022 HEDIS AND FIVE-STAR QUALITY MEASURES REFERENCE GUIDE HEDIS STAR MEASURE AND REQUIREMENTS DOCUMENTATION NEEDED CPT/CPTII CODES Annual Wellness Exam Measure ID: AHA, PPE, COA Description: Measurement Year Lines: Age: Medicare 18yrs & Older Blood Pressure Control Measure ID: CBP or CDC9 Description: EVERY VISIT Lines: Age: Medicare 18yrs - 75yrs the HEDIS Measurement Year (MY) 2020 & 2021 Volume 2 Technical Speciications. HbA1c Testingindicator. !(!0*21/*.-4;K@48G9-.BYBGNPTUT3? 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. SNPs have reported the following measures since HEDIS Measurement Year (MY) 2016: Please see the link below for the most recent SNP HEDIS Performance Report. SNPs can use HEDIS performance data to identify opportunities for improvement, monitor the success of quality improvement initiatives, track improvement and provide a set of measurement standards that allow comparison with other plans. Tobacco Cessation Program. 0000003369 00000 n QARR List of Required Measures (Table 1) lists by product the measures required for submission. <<1EA954AB0783464B894F5E09E2AC546B>]/Prev 295107/XRefStm 1946>> xref 0000022148 00000 n Volume 2:Technical Specifications for HealthPlans. Intent:Antibiotics prescribed for acute respiratory conditions are a large driver of antibiotic overuse. 0000011691 00000 n }{7wi\vLU#)J1i#} ;?0L1$Zh\D#$M},[Na_MxQ~+EYs}VgeWPL;hhWs, k>^c-sNWAOHKd3:o ThisclinicaltopicisnowaddressedinthenewAdvanceCarePlanningmeasure. . Intent:The 2019 American Geriatrics Society Beers Criteria recommendthat benzodiazepinesbeavoidedinolderadults. 0000010005 00000 n lock cytology performed between 2020-2022. Every year,NCQA updates and releases the Healthcare Effectiveness Data and Information Set (HEDIS). More than 200 million people are enrolled in plans that report HEDIS results. 4 0 obj 0000004692 00000 n 0000012465 00000 n 0000002321 00000 n VA outpatient measures closely follow the specifications set forth by the National Committee for Quality Assurance (NCQA), Healthcare Effectiveness Data and Information Set (HEDIS). hbbd```b``akA$%Xd6dbe`X,,r, f_k0yDV[I vS _"A8^FO 0 E Terms of Use, Patient-Centered Specialty Practice (PCSP), Credentials Verification Organization (CVO), Managed Behavioral Healthcare Organization (MBHO), Health Information Technology Prevalidation Programs, Virtual Seminars, Webinars and On-demand Training, Advertising and Marketing Your NCQA Status, HEDIS Electronic Clinical Data Systems (ECDS) Reporting, HEDIS Medicare Health Outcomes Survey and the Medicare Health Outcomes Survey Modified, NCQA collects HEDIS data from health plans. Bng vic tip tc s dng trang web ca chng ti, qu v ng vi Chnh Sch V Quyn Ring T v iu Khon S Dng ca chng ti.. OK endstream endobj 4921 0 obj <. endobj hUYk@+R=`;Q&8[[Ewfq= F$\ S4x2$ !\DDFk-bG,"imAsL]KA$D1UdlG:ibkz3OvDn svD~0${xH4XMs\x-'IkMg51za#A3h!7O,-0Yn "71*~sK(_~KutedF},&KVL}Ve>Yj`SQC}OWpt\c7Ij][ K=[> 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$[G@MY?mcwo;oN:p2 NCQAwillconcentrateeffortsontheoutcome-basedHbA1cControlforPatientsWithDiabetesmeasure. 2579 0 obj <>stream The UB Codes contained in the HEDIS specifications may be used by health plans and other health care delivery organizations for the purpose of calculating and reporting HEDIS measure results or using HEDIS measure results for their internal quality improvement purposes. 0000010320 00000 n D('@E$xVK`"P6 ?L dvC) ? 4950 0 obj <>stream Copyright 2023 National Committee for Quality Assurance. Summary Table of Measures, Product Lines and Changes 1 HEDIS MY 2022, Volume 2 HEDIS VOLUME 2 MY 2022 . QLeRQ~{?$u>%)G7,]m?oaS`AD>O)>fC*b9Zj #b&=c;m4lYVy7&>c)|5+Z7Sw 3tUfQ|x]zZ>!B2P10d@9>UE*EE$6PZtegv:(J5#,ojt1mGL+9AYdeQ4ec`"omT2%^(_&/>~8_+7F]e*}1b>(Q}\4t0 5kET"gDka6FT@-hU \N!VGk}J.V29< ( 0000011393 00000 n 1{z>Y^1(|@jF{iPu~tPmu]1fGdBg8T]\;j/y=d[cug.HPVOIFf?,e?~Z.IieF;&QU;L.ltC9=Ah&Bo*Xn;al}tZF M&3#n$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. 0000010141 00000 n HEDIS Technical Specifications include a complete list of new and updated HEDIS measures with instructions on data collection and guidelines for calculations and sampling. endstream endobj startxref . B. Quantifiable Measures. 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: NCQAisretiringthefollowingmeasures/indicators: Formoreinformation,refertothefullmeasurespecificationsinHEDISMY2022Volume 2:Technical Specifications for HealthPlans. hb```b``{ B@16=(?6vl& $. 0000009785 00000 n We do not share your information with third parties. JFIF ` ` C Recognizing that HEDIS measures have traditionally been specified for health plan reporting, NCQA developed the Rules for Allowable Adjustment of HEDIS to accommodate the application of HEDIS measures to various levels of the health care system for quality improvement initiatives. NCQA collects HEDIS data from health plans and other health care organizations. To learn more. 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. Recognizing that HEDIS measures have traditionally been specified for health plan reporting, NCQA developed the Rules for Allowable Adjustment of HEDIS to accommodate the application of HEDIS measures to various levels of the health care system for quality improvement initiatives. 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). 0000008074 00000 n Laboratory Benefit Management. 8 0 obj ThenewestadditionstoHEDISaddresspatient-centered care, as well assafetyand appropriateness. <> 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 ;(Y}e"XmT8,/l EP5ePVm8,&T2X, +|oM}> O~rEUnM~#jOicJ@2Yus https:// hWO`06~@)N@&d.6l5@[)"$$dm29R1$2.K3LH(y ]3SISTM}~/'Ys9Z @ R M+[|Qs0@!| T8E#F>x=-g? Save your favorite pages and receive notifications whenever theyre updated. High-qualityhealthcaremustbeequitablehealthcare. Advancecareplanningisassociatedwithimprovedqualityoflife,increasedprovidertrustanddecreasedhospitalization. List and define all quantifiable measures used in this activity. Antibiotics prescribed for acute respiratory conditions are a large driver of antibiotic overuse. click here for a discussion of this new measure. Sign up to get the latest information about your choice of CMS topics. 51 0 obj <>stream Immunization Schedules. Tables 1-3 below include . 0000000016 00000 n 0000013541 00000 n For the denominator, NCQA added ED visits for unintentional or undetermined overdose for commonly used drugs with addiction potential in any diagnosis position. NCQAplanstoexpandtheraceandethnicitystratificationstoadditionalHEDISmeasuresoverseveralyearstohelpreducedisparitiesincareamongpatientpopulations. 0000047019 00000 n 0000003808 00000 n Anticipated Release Date: September 2023. 0000007305 00000 n Avoidance of Antibiotic Use. %%EOF HEDIS Measure PCCP Well-Child Visits First 15 Months 74.74% Well-Child Visits 1530 Months 81.79% 0000133484 00000 n NCQA also revised themeasuredenominatortoreflectthenumberofmembers,ratherthanmemberyears, andtoincludesubstanceusedisordercodes; andrevisedtheagegroupsforreportingto1317,1864and65+. HEDIS 2022 Percentile : HEDIS : Annual Dental Visit (Ages 2-20 years) 121,271 . w !1AQaq"2B #3Rbr REQUIRED HEDIS1 AND CAHPS2 MEASURES FOR HEDIS REPORTING YEAR 2022 Summary of Changes to Measure List: Added the following measures. Table 7a: CHIP-MCO Results for 2022 (MY 2021) HEDIS Measures CHIP-MCO @_B^GR NCQA defines how data can be collected for a measure: 0000009572 00000 n ND-)8^r|\q=.Kx.!J"G8IE NCQArevisedthemeasurestructurefromutilizationtodiagnosed-prevalenceofsubstanceuseandupdatedthenameto. The technical specifications for organizations providing Medicaid long-term services and supports (LTSS). 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). Visitors to this page often checkHEDIS FAQsor ask a question throughMyNCQA. The rules provide flexibility for evaluating different populations without altering measures clinical intent (e.g., removal of continuous enrollment or product-line criteria). ). Additionally,NCQA invites you to join HEDIS Users Group forinside information on HEDIS development and future directions. 0000133309 00000 n HEDIS includes measures for physicians, PPOs and other organizations. CPT: 87070, 87071, 87081, 87430, 87650-87652, 87880 HEDIS Tip Sheet - Pediatric Measures Key HEDIS Factors to Consider S/K[ AOIp 3 0 obj 0000021716 00000 n HEDIS SPECIFICATION OVERVIEW 2021 KEY: Indicates triple weight measure Revised January 2021 All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation. Share this page with a friend or colleague by Email. Share this page with a friend or colleague by Email. ("$e 0)*[sNwL(((((()#(1/I\HlQ3F7n6 e#+}:~9'M]Fn*m(jfe Z)TRPQZWV+9F x_O. <> Access/Availability of Care. Three of the four diabetes measures rate at the Wellcare dng cookie. DL U `j@ +Y&F] S-ppo>8w4Dg`` C InitiationandEngagementofAlcoholandOtherDrugAbuseorDependence. HEDIS Measure - Term for how each domain of care is further broken down. Quality Compass 2023 Commercial Premier Edition-Trended Data (MY 2022, MY 2021, MY 2020) with Data Exporter. 0000016906 00000 n rFZ /CvN`(,b$CoyeL`Y6P-@ 0000002938 00000 n HEDIS is a source for data contained in the California Health Care Quality Report Cards obtained from Quality Compass2022 and is used with the permission of the National Committee for Quality Assurance (NCQA). Encounter data is crucial for demonstrating accurate quality performance to the Department of Health Care Services (DHCS). G-3245 Beecher Road Flint, Michigan 48532 HEDIS Measures. 2527 0 obj <> endobj That is why we publish what we learn from HEDIS in many forums and formats. To be able to identify andreduce disparitiesin care, the first step must be measuring and reportingon. ,wBInd!d98{9|/.Y1&7wULt~s`GgvXT\/T}[_}bVT=TXk;e*ZkQXH#7hUxQ"zZdP> User may need additional software to use the Product, and NCQA is not responsible for such additional software. The Cigna name, logos, and other Cigna marks are owned by Cigna Intellectual Property, Inc. 2021 Cigna INT_21_96354_C 919034 c For MY 2022, HEDIS added three new measures, retired three measures/indicators and changed seven existing measures and two cross-cutting topics that address enhancements across multiple measures. Np1W>?,Y{ 9745 0 obj <> endobj xref ?^>&d;ijSl+EPe7"z_?0Kx)uQ Share this page with a friend or colleague by Email. endstream endobj 27 0 obj <> endobj 28 0 obj <> endobj 29 0 obj <>stream ComprehensiveDiabetesCare/HemoglobinA1cControlforPatientsWithDiabetes,EyeExamPerformedforPatientsWithDiabetes,BloodPressureforPatientsWithDiabetes. How are rates calculated? HEDISpublicationsareavailableas electronic publications. <> Quality Compass 2023 Commercial-Trended Data (MY 2022, MY 2021, MY 2020) As low as $7,690.25. performance. The information provided in this HEDIS QRG is to help you improve your practice's HEDIS rates. o GRs_$ [EN=_sRs 1F/T ? Plans must purchase the HEDIS 2022 Technical Specifications for Health Plans for specifications of the required HEDIS measures. A,0QV ElectronicClinicalDataSystem(ECDS)Reporting. HEDIS measures performance in health care where improvements can make a meaningful difference in peoples lives. 0000014293 00000 n Automatic . 0000017889 00000 n Rate 2: Two additional well-child visits 15 to 30 months. Part D measures are displayed in Tables 2 and 3 for MA-PD and PDP contracts, respectively. $4%&'()*56789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz ? 2527 53 0000024625 00000 n 0000005411 00000 n HEDIS MY 2022 Measures Applicable to: Commercial Medicaid Medicare Changes for HEDIS MY 2022 General Guidelines for Data Collection and Reporting 0000035753 00000 n . <> Follow-UpAfterEmergencyVisitDepartmentVisitforAlcoholandOtherDrugDependence/Follow-UpAfterEDVisitforSubstanceAbuse. Island managed care plans must provide performance measure data, specifically HEDIS, to the Office of Health . IdentificationofAlcoholandOtherDrugServices/DiagnosedSubstanceUseDisorders. %PDF-1.6 % <> endobj AntibioticUtilizationforRespiratoryConditions. For HEDIS measures that report age cohorts beyond 19 years old, rates reported below only extend to 19 years old to align with CHIP enrollment and are noted as such. 0000007996 00000 n CJ)8kPqQy!h\ADICp%F$NhG-EL'nU%mQ*1HPl. 0000050943 00000 n This table contains the measures and brief descriptions that are included in HEDIS MY 2022. 1CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). x Updated Guideline 7: Measurement Period Adjustments. CMS released the Plan Year 2023 Nationwide Quality Rating System Public Use File (PUF) (ZIP) to outline underlying measure data as well as star ratings for all eligible Qualified Health Plan (QHP) issuers, operating in all Exchange types, that received QRS star ratings for Plan Year 2023. 0000009893 00000 n NCQAs HEDIS Value Set Directory (VSD) includes the necessary third-party codes for use with adjusted measure specifications.
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