Other changes assure that HEDIS will be useful, valid and reliable for a new era of medicine. Health Insurance Marketplace Quality Initiatives | CMS performance reported in the 2022 Quality Compass (measurement year 2021) . 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. HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). The information provided in this HEDIS QRG is to help you improve your practice's HEDIS rates. 0000009457 00000 n ThiseffortbuildsonNCQAsexistingworkdedicatedtotheadvancinghealthequityindataandqualitymeasurement. PDF 2023 HEDIS Measures - McLaren Health Plan Intent:Antibiotics prescribed for acute respiratory conditions are a large driver of antibiotic overuse. PDF Rhode Island Medicaid Dental Program UnitedHealthcare Dental Annual 0000035489 00000 n HEDIS nonsurvey measures for organizations; instructions on data collection for each measure; general guidelines for calculations and sampling. 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 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 1343 0 obj <>/Filter/FlateDecode/ID[<2D87A2A235A2694FB1EEAE97FC4AEC75>]/Index[1320 39]/Info 1319 0 R/Length 109/Prev 246119/Root 1321 0 R/Size 1359/Type/XRef/W[1 3 1]>>stream 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. <<1EA954AB0783464B894F5E09E2AC546B>]/Prev 295107/XRefStm 1946>> Island managed care plans must provide performance measure data, specifically HEDIS, to the Office of Health . inappropriate prescribing for upper respiratory infections, pharyngitis and acute bronchitis. hbbd``b@Bf` $30`l/@ Healthcare Effectiveness Data and Information Set (HEDIS) 1067 0 obj <> endobj . . HEDIS Diabetes Measures - Understanding Comprehensive Care Anticipated Release Date: September 2023. CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). B. Quantifiable Measures. PDF Hedis Cheat Sheet 2022 - 2023 0000001386 00000 n The HEDIS measurement set is sponsored, supported and maintained by NCQA. To be able to identify andreduce disparitiesin care, the first step must be measuring and reportingon. Trackingantibioticprescribingforallacute respiratory conditionswillprovide context about a healthplansoverall antibiotic use when viewedwiththree HEDIS measures ofappropriatetesting and inappropriate prescribing for upper respiratory infections, pharyngitis and acute bronchitis. 2 Technical Specifications Update, HEDIS 2020 (MY 2019) Risk Adjustment Tables, HEDIS 2020 Measure Trending Determinations, Quality Rating System 2020 Technical Specifications Update, Volume 3 2020 Technical Specifications Update, Volume 3 2020 Validated Member-Level File Layout, HEDIS MY 2023 Measure Trending Determinations, MY 2023 Validated Member-Level File Layout (, Order this publication (anticipated release date: May 2024). gbv[Dp[,tkg`h`PR``46R @0ft@ ublH$`@K WH@uX^$28C23n`Rbts&H-dpo]n0ch K$l7@ LD%@H00r'UvU h# Intent:The 2019 American Geriatrics Society Beers Criteria recommendthat benzodiazepinesbeavoidedinolderadults. The Centers for Medicare & Medicaid Services (CMS) uses a five- Diabetes blood sugar control Diabetes kidney function Discharge medication reconciliation Osteoporosis management Cardiovascular disease statin management Breast cancer screening Medication review Pain screening Colorectal cancer screening Controlling high blood pressure QARR List of Required Measures (Table 1) lists by product the measures required for submission. Follow-UpAfterEDVisitforSubstanceUse. 2022 Value Based Payment Reporting Requirements - New York State hb```b``{ B@16=(?6vl& $. Table 4: PCCP HEDIS Performance Measures - MY 2021 . 0000000016 00000 n That is why we publish what we learn from HEDIS in many forums and formats. Copyright 2023 National Committee for Quality Assurance. For MY 2022, HEDIS added three new measures, retired three measures/indicators and changed seven existing measures and two cross-cutting topics that address enhancements across multiple measures. HEDIS Measurement Year 2022 Measures Measure Description: The percentage of children newly prescribed attention-deficit/ hyperactivity disorder ADHD medication who had at least three follow-up care visits within a 10-month period, one of which was within 30 days of when the first ADHD medication was dispensed. ElectronicClinicalDataSystem(ECDS)Reporting. The approved method for auditing the HEDIS production process, including an information systems capabilities assessment, an evaluation of compliance with HEDIS specifications and standards that Certified HEDIS Compliance Auditors must use when conducting a HEDIS audit. High-qualityhealthcaremustbeequitablehealthcare. Data from the 2020 measurement period (2022 Star Ratings) help us understand how the PHE impacted the care delivery system. <> HUG members are health care professionals who produce, report and interpret HEDIS data. hXmTW3`IBH5@) ZmmP)pZA;H)Tt=lM"VPH`[[Z?j]MTz User may need additional software to use the Product, and NCQA is not responsible for such additional software. HEDIS survey measures and standardized surveys from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) program. xref lock 0000050943 00000 n ( w !1AQaq"2B #3Rbr %PDF-1.4 % HEDIS Measure PCCP Well-Child Visits First 15 Months 74.74% Well-Child Visits 1530 Months 81.79% 1CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). h^3VN,vAO]{Q@v gK2CxD]*{Dv= Px k7j^AEE]iQcWA/]?N8MhIB HA]2kNHAE Vc"c)\v1s9]OA2mJ)$'8 PDF HEDIS Quick Reference Guide 0000001035 00000 n PDF 2022 Star Ratings Fact Sheet ND-)8^r|\q=.Kx.!J"G8IE DL U `j@ +Y&F] S-ppo>8w4Dg`` C 0000032016 00000 n 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. endstream endobj startxref 0000008644 00000 n endstream endobj startxref 0000021981 00000 n 0000016920 00000 n 0000133484 00000 n Visitors to this page often checkHEDIS FAQsor ask a question throughMyNCQA. ;(Y}e"XmT8,/l EP5ePVm8,&T2X, +|oM}> O~rEUnM~#jOicJ@2Yus NCQAwillconcentrateeffortsontheoutcome-basedHbA1cControlforPatientsWithDiabetesmeasure. 1358 0 obj <>stream Care for Children Prescribed ADHD Medication Initiation and Continuation measures. 0000010486 00000 n 0000047520 00000 n %%EOF VA has utilized data from NCQA's Quality Compass to establish regional averages for hospitals that fall within geographic boundaries that match areas covered by Veterans Integrated Service Networks (VISN). PDF MY 2023 Summary Table of Measures Product Lines Changes **For Complaints about the Plan PDF Required HEDIS and CAHPS Measures for HEDIS Reporting Year 2022 ?^>&d;ijSl+EPe7"z_?0Kx)uQ This process ensures that HEDIS measures remain relevant and feasible for implementation. 0000011691 00000 n Visitors to this page often check HEDIS FAQs, QRS FAQs, or ask a question through My NCQA. As low as $6,835.25. An official website of the United States government endstream Find Doctors, Drugs and Facilities. 0000008747 00000 n endobj 0000019234 00000 n 0000014654 00000 n Intent:Advancecareplanningisassociatedwithimprovedqualityoflife,increasedprovidertrustanddecreasedhospitalization. PDF Measure Name Abbreviation Measure Description EFFECTIVENESS OF CARE Auditsprotect results validity and reliability. MY 2002 was the yearfirst that follow-up rates were reported. Save your favorite pages and receive notifications whenever theyre updated. HSn0+THK[iF(P=2@oA.kY"cL@YG6u}(K]*-50 j"1J0B(E$akG) For example, 2022 claims, encounters, and other HEDIS data are submitted throughout 2022. Encounter data is crucial for demonstrating accurate quality performance to the Department of Health Care Services (DHCS). 0000044978 00000 n New digital measures reduce the burden of reporting quality results. HbA1c Testingindicator. Social Determinants: Our Statement with TJC, NQF Was Just the Start. Advancecareplanningisassociatedwithimprovedqualityoflife,increasedprovidertrustanddecreasedhospitalization. 2579 0 obj <>stream II. !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 HEDIS includes measures for physicians, PPOs and other organizations. 1320 0 obj <> endobj endstream endobj 30 0 obj <>stream Formoreinformation,refertothefullmeasurespecificationsinHEDISMY2022. . !9g=SW[h ,3%`~,Z-"3b~lv?.cKQZLHJ*??Y$t)mvdQZt6F^_"g&Oa}t%&QZ./w|PCZE9vG2{m!miVv| Q@?\ti+3#{lgi 0 1 0 obj endstream endobj startxref The Inventory lists each measure by program, reporting measure specifications including, but not limited to, numerator, denominator, exclusion criteria, Meaningful Measures domain, measure type, and National Quality Forum (NQF) endorsement status. Thismeasurehas beenretired. Follow-UpAfterEmergencyVisitDepartmentVisitforAlcoholandOtherDrugDependence/Follow-UpAfterEDVisitforSubstanceAbuse. Rates for the HEDIS measures were compared to corresponding Medicaid percentiles; comparison results are provided in the tables. 0000013436 00000 n 0000133309 00000 n HEDIS CHEAT SHEET 2022 - 2023 Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Documented yearly for ages 3-17. 0000007996 00000 n Two rates are reported. Trackingantibioticprescribingforallacute respiratory conditionswillprovide context about a healthplansoverall antibiotic use when viewedwiththree HEDIS measures ofappropriate. PDF HEDIS SPECIFICATION OVERVIEW 2021 - Cigna C*@ep!%E#-nb4LM SNPs reported the following measures in HEDIS 2016: Colorectal Cancer Screening Care for Older Adults Use of Spirometry Testing in the Assessment and Diagnosis of COPD Pharmacotherapy Management of COPD Exacerbation Controlling High Blood Pressure Persistence of Beta-Blocker Treatment After a Heart Attack Each managed care plan's calculated rates for the NCQA HEDIS Measurement Year 2021 measure set were validated as part of the NCQA HEDIS Compliance Audit and assigned one of NCQA's outcome designations. (HEDIS) measures that assess quality of health care provided to Blue Shield Promise Medi-Cal members. ]c\RbKSTQ C''Q6.6QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ T " |@Z-Q Outpatient Compare Data | Veterans Affairs A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. hb``` rB cc`ahpb`QN`|A(WY2c0Oeox%{$M94 NSqo This manual describes in detail only the NYS-specific measures. 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). PDF HEDIS Tip Sheet - Pediatric Measures - Sunshine Health endobj InitiationandEngagementofAlcoholandOtherDrugAbuseorDependence. endstream endobj 31 0 obj <>stream performance reported in the 2022 Quality Compass (measurement year 2021) for all lines of business that reported measurement year 2021 .
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