0000017889 00000 n 0000009457 00000 n 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. Individual HEDIS Measures Sheets. ,wBInd!d98{9|/.Y1&7wULt~s`GgvXT\/T}[_}bVT=TXk;e*ZkQXH#7hUxQ"zZdP> AntibioticUtilizationforRespiratoryConditions. 0 Updates on HEDIS Measures MY2022. 0000010811 00000 n 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. 0000107074 00000 n gbv[Dp[,tkg`h`PR``46R @0ft@ ublH$`@K WH@uX^$28C23n`Rbts&H-dpo]n0ch K$l7@ LD%@H00r'UvU h# CJ)8kPqQy!h\ADICp%F$NhG-EL'nU%mQ*1HPl. Measure Changes Care for Older Adults (COA) - -Removed Advanced Care Planning indicator from COA . That is why we publish what we learn from HEDIS in many forums and formats. 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 HEDISpublicationsareavailableas electronic publications. 0000021716 00000 n 1311 0 obj <>stream 0000011393 00000 n 0000006215 00000 n C*@ep!%E#-nb4LM 0000035489 00000 n Other changes assure that HEDIS will be useful, valid and reliable for a new era of medicine. Three of the four diabetes measures rate at the $4%&'()*56789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz ? andaddedtwocross-cuttingexclusions:palliativecareandadvancedillness/frailty. Intent:The 2019 American Geriatrics Society Beers Criteria recommendthat benzodiazepinesbeavoidedinolderadults. stream Tobacco Cessation Program. VA outpatient measures closely follow the specifications set forth by the National Committee for Quality Assurance (NCQA), Healthcare Effectiveness Data and Information Set (HEDIS). endstream endobj startxref Volume 2:Technical Specifications for HealthPlans. NCQAwillconcentrateeffortsontheoutcome-basedHbA1cControlforPatientsWithDiabetesmeasure. 0000004794 00000 n X `q@ A`J~m ]l b| 0jHX=x3||DqGTt|\V~Fu3c,$;$c9 -Kd"bv.CXb%*qS-J`}V1h(l1y|8Tr46hOJ 0000022148 00000 n Find Doctors, Drugs and Facilities. hWO`06~@)N@&d.6l5@[)"$$dm29R1$2.K3LH(y ]3SISTM}~/'Ys9Z @ R M+[|Qs0@!| T8E#F>x=-g? 0 %%EOF 0000002169 00000 n ThisclinicaltopicisnowaddressedinthenewAdvanceCarePlanningmeasure. HEDIS/CAHPS Measures Required for HP AccreditationCommercial *The weight column indicates the weight of the item (maximum value = 3) in the overall score calculation. Visitors to this page often checkHEDIS FAQsor ask a question throughMyNCQA. HEDIS is a source for data contained in the California Health Care Quality Report Cards obtained from Quality Compass2022 and is used with the permission of the National Committee for Quality Assurance (NCQA). HSMk@WHM[Zl8 p ccwVrLCV{6GfP!Kh~&)/uY>ak9 xKK@ { a;;:/DCXlcf_YB^Q(przeq0)# 0y,-h6-2Y=Vf]+[eq[&ge1heucd;)CzGE"z&D%z`SS?I1ZOFb ?=xb =WV!Nfvb)e:R '$t^OWoM9o{$)GlCeSkftDJbR2$n{Y4O}0m$&pmT|yQ;x/8Z$[G@MY?mcwo;oN:p2 hb``` rB cc`ahpb`QN`|A(WY2c0Oeox%{$M94 NSqo VA has utilized data from NCQA's Quality Compass to establish regional averages for hospitals that fall within geographic boundaries that match areas covered by Veterans Integrated Service Networks (VISN). . By accessing the Product, the User is deemed to have accepted the terms and conditions of this Usage Agreement. A list of potential measures for initial stratification in MY2022 are as follows: Controlling High Blood Pressure (CBP) Comprehensive Diabetes Care (CDC) Antidepressant Medication Management (AMM) Follow-Up After Emergency Department Visit for People with Multiple High-Risk Chronic Conditions (FMC) Two rates are reported. Trackingantibioticprescribingforallacute respiratory conditionswillprovide context about a healthplansoverall antibiotic use when viewedwiththree HEDIS measures ofappropriate. vzp`}jArJ;,-r1cb?>~XVU(pAi-Im kC#)}i^_ eMRNxz;e~FOL:epYMit *9(66a?`4 /[2u0@G5Q^+NDV&h$!~_sO {9oHp3N)I4BP5N1K0Up ]%x2P1xvk?7?]k'a Quality Compass 2023 Medicaid-Trended Data (MY 2022, MY 2021) As low as $5,220.25. HEDIS nonsurvey measures for organizations; instructions on data collection for each measure; general guidelines for calculations and sampling. Data from the 2020 measurement period (2022 Star Ratings) help us understand how the PHE impacted the care delivery system. Quality Compass 2023 Commercial Premier Edition-Trended Data (MY 2022, MY 2021, MY 2020) with Data Exporter. Overview of the HEDIS measurement set and how the data are used. endstream endobj 27 0 obj <> endobj 28 0 obj <> endobj 29 0 obj <>stream %&'()*456789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz 1{z>Y^1(|@jF{iPu~tPmu]1fGdBg8T]\;j/y=d[cug.HPVOIFf?,e?~Z.IieF;&QU;L.ltC9=Ah&Bo*Xn;al}tZF M&3#n$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. Utilization and Risk Adjusted Utilization. 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. @_B^GR 0000032016 00000 n g'jQL[@tsho-0;F3a!~;F^MHFG"Y#HX@=<71AcL\oxdkw2& +i 0000010486 00000 n 0000019234 00000 n 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). Most measure score changes between the 2022 and 2023 Star Ratings were small overall in both directions. Visitors to this page often check HEDIS FAQs, QRS FAQs, or ask a question through My NCQA. Withthisdeprescribing measure, there isan opportunityto promote harm reduction by assessing progress in appropriately reducing benzodiazepine use in the older adult population. !9g=SW[h ,3%`~,Z-"3b~lv?.cKQZLHJ*??Y$t)mvdQZt6F^_"g&Oa}t%&QZ./w|PCZE9vG2{m!miVv| Q@?\ti+3#{lgi <> 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. 0000004757 00000 n HEDIS Measure PCCP Well-Child Visits First 15 Months 74.74% Well-Child Visits 1530 Months 81.79% 0000001946 00000 n HEDIS Measures HEDIS includes more than 90 measures across 6 domains of care: Effectiveness of Care. 2579 0 obj <>stream Healthcare Efectiveness Data and Information Set (HEDIS ) rates can be calculated in two ways: administrative data or hybrid data. ComprehensiveDiabetesCare/HemoglobinA1cControlforPatientsWithDiabetes,EyeExamPerformedforPatientsWithDiabetes,BloodPressureforPatientsWithDiabetes. 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. NCQAisretiringthefollowingmeasures/indicators: Formoreinformation,refertothefullmeasurespecificationsinHEDISMY2022Volume 2:Technical Specifications for HealthPlans. Advanced Care Planning. Every year,NCQA updates and releases the Healthcare Effectiveness Data and Information Set (HEDIS). To learn more, click here for a discussion of this new measure. Tables 1-3 below include . The Cigna name, logos, and other Cigna marks are owned by Cigna Intellectual Property, Inc. 2021 Cigna INT_21_96354_C 919034 c R'A@>r 5^[qLp.p*DB24V,mb66vA8kwFvM@gf` r B. Quantifiable Measures. 0000006694 00000 n G-3245 Beecher Road Flint, Michigan 48532 hb```@(1iNlpiK Y_LjV_0`II:~|=0f8+~'8eW!Izw(I~>rIq9NM>8>N7*ksO6Qg4h%&. 0000008747 00000 n 6 0 obj %PDF-1.7 0000044978 00000 n Measures relate to many significant public health issues such as cancer, heart disease, behavioral health and diabetes. 0000010005 00000 n 0000008708 00000 n Anticipated Release Date: July 2023. endstream endobj startxref 0000024625 00000 n Save your favorite pages and receive notifications whenever theyre updated. Anticipated Release Date: September 2023. endstream endobj startxref SUMMARY TABLE OF MEASURES, PRODUCT LINES AND CHANGES . ThiseffortbuildsonNCQAsexistingworkdedicatedtotheadvancinghealthequityindataandqualitymeasurement. hbbd```b``akA$%Xd6dbe`X,,r, f_k0yDV[I vS _"A8^FO 0 E <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S>> HEDIS includes more than 90 measures across 6 domains of care: Under contract to CMS, NCQA supports the implementation of the HEDIS Medicare Health Outcomes Survey and the Medicare Health Outcomes Survey Modified. 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. In these cases, age stratifications will differ from HEDIS MY 2021 technical specifications. 0000001035 00000 n NCQA screens, trains and certifies organizations that collect or audit data for health plans and providers. 9745 0 obj <> endobj xref 0000017732 00000 n Effective 2022, the Promise VIP Program is now called Promise Quality Performance Incentive (PQPI). NCQA also revised themeasuredenominatortoreflectthenumberofmembers,ratherthanmemberyears, andtoincludesubstanceusedisordercodes; andrevisedtheagegroupsforreportingto1317,1864and65+. HEDIS quality measures for Accountable Care Organizations. 0000020276 00000 n 0000068208 00000 n means youve safely connected to the .gov website. . For more information regarding future quality measure consideration and selection, please visit Measure Selection | CMS MMS Hub. Save your favorite pages and receive notifications whenever theyre updated. To learn more. {+Ed. NYS will calculate the measure result for MY2021 2 - For measures that you may have reported using the hybrid sample in the PLD for QARR, **For Complaints about the Plan HEDIS MY 2022 Measures Applicable to: Commercial Medicaid Medicare Changes for HEDIS MY 2022 General Guidelines for Data Collection and Reporting endstream The information provided in this HEDIS QRG is to help you improve your practice's HEDIS rates. ThenewestadditionstoHEDISaddresspatient-centered care, as well assafetyand appropriateness. This process ensures that HEDIS measures remain relevant and feasible for implementation. Medicaid benchmarks displayed in these tables come from NCQA's 2022 Quality Compass for measurement year 2021. MentalHealthUtilization/DiagnosedMentalHealthDisorders. Experience of Care. 0000133309 00000 n m="=jVvyNc{ MHS leadership and healthcare providers continually assess clinical performance data to ensure beneficiaries receive safe, high quality care in military treatment facilities (MTFs) and TRICARE network hospitals. S/K[ AOIp 9745 36 0000036100 00000 n hb```b``{ B@16=(?6vl& $. The Healthcare Effectiveness Data and Information Set (HEDIS) is one of health cares most widely used performance improvement tools. UseofImagingStudiesforLowBackPain. Ur"J,3Xhi"k;}06]rn(0i HEDIS includes measures for physicians, PPOs and other organizations. 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. <> 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 0000014293 00000 n 1105 0 obj <>/Filter/FlateDecode/ID[]/Index[1067 245]/Info 1066 0 R/Length 162/Prev 876729/Root 1068 0 R/Size 1312/Type/XRef/W[1 2 1]>>stream 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. Thismeasurehas beenretired. NCQArevisedthemeasurestructurefromutilizationtodiagnosed-prevalenceofsubstanceuseandupdatedthenameto. %PDF-1.6 % 0000047019 00000 n HTn0*hk!4J[&5i7Y%I yf Copyright 2023 National Committee for Quality Assurance. 0000000016 00000 n 3 0 obj Intent:Advancecareplanningisassociatedwithimprovedqualityoflife,increasedprovidertrustanddecreasedhospitalization. x Updated Guideline 7: Measurement Period Adjustments. reportingforthreeHEDISmeasures:Childhood Immunization Status, Immunizations for AdolescentsandMetabolic Monitoring for ChildrenandAdolescents on Antipsychotics. Laboratory Benefit Management. 0000004219 00000 n Include a goal or benchmark for each measure. 0000010320 00000 n DeprescribingofBenzodiazepinesinOlderAdults. https:// Np1W>?,Y{ or 0000013541 00000 n startxref ( 0000004562 00000 n Follow-UpAfterEmergencyVisitDepartmentVisitforAlcoholandOtherDrugDependence/Follow-UpAfterEDVisitforSubstanceAbuse. Encounter data is crucial for demonstrating accurate quality performance to the Department of Health Care Services (DHCS). 0000008644 00000 n 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 Visitors to this page often checkHEDIS FAQsor ask a question throughMyNCQA. To be able to identify andreduce disparitiesin care, the first step must be measuring and reportingon. !(!0*21/*.-4;[email protected]? <> CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). .gov \\R4G_$g$T!7(9 Advancecareplanningisassociatedwithimprovedqualityoflife,increasedprovidertrustanddecreasedhospitalization. 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 endobj 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. Intent:Antibiotics prescribed for acute respiratory conditions are a large driver of antibiotic overuse. 1320 0 obj <> endobj 1CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). Table 1: Changes in Part C Measure Scores from 2021 to 2023 Star Ratings for MA Contracts A,0QV HEDIS Tip Sheet - Pediatric Measures -Look back period: July 1 of the year prior to June 30 of the measurement year. 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. InitiationandEngagementofAlcoholandOtherDrugAbuseorDependence. P}^bGx{Q1F b~/>@ e# 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. 0000050943 00000 n 0000004692 00000 n %%EOF HEDIS Measure - Term for how each domain of care is further broken down. 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. endstream endobj 33 0 obj <>stream 0000012465 00000 n 0000011150 00000 n 51 0 obj <>stream Terms of Use, Every year,NCQA updates and releases the Healthcare Effectiveness Data and Information Set (HEDIS. HEDIS data help identify performance gaps and establish realistic targets for improvement. 0 Members can access the latest news about measuring performance and gain insight into how HEDIS evolves. cytology performed between 2020-2022. 0000012538 00000 n 0000004224 00000 n 4920 0 obj <> endobj 0000086512 00000 n REQUIRED HEDIS1 AND CAHPS2 MEASURES FOR HEDIS REPORTING YEAR 2022 Summary of Changes to Measure List: Added the following measures. 2527 53 Antibiotics prescribed for acute respiratory conditions are a large driver of antibiotic overuse. Access/Availability of Care. 0000029366 00000 n Wellcare dng cookie. Auditsprotect results validity and reliability. o GRs_$ [EN=_sRs 1F/T ? Rates for the HEDIS measures were compared to corresponding Medicaid percentiles; comparison results are provided in the tables. %PDF-1.4 % Social Determinants: Our Statement with TJC, NQF Was Just the Start. NCQAalsorevisedthechildandadolescentagegroupsforreportingto117. You will be prompted to log in to your NCQA account. 0000017803 00000 n The rules provide flexibility for evaluating different populations without altering measures clinical intent (e.g., removal of continuous enrollment or product-line criteria). NCQA Communications Every year, NCQA updates and releases the Healthcare Effectiveness Data and Information Set (HEDIS). HEDIS digital future has begun. 0000051029 00000 n NCQAplanstoexpandtheraceandethnicitystratificationstoadditionalHEDISmeasuresoverseveralyearstohelpreducedisparitiesincareamongpatientpopulations. performance. ?^>&d;ijSl+EPe7"z_?0Kx)uQ (7/1/prior yr. - 6/30/measurement year). xPX]NG&)R.ng} (1$JMYpwV:] For example, 2022 claims, encounters, and other HEDIS data are submitted throughout 2022. Avoidance of Antibiotic Use. This process ensures that HEDIS measures remain relevant and feasible for implementation. The Rules for Allowable Adjustments are included in the HEDIS Volume 2 publication after the applicable HEDIS measure specifications. hbbd```b``"gIw ""7|-``qT3l0; fH0DHI@H_mj> _ HEDIS SPECIFICATION OVERVIEW 2021 KEY: Indicates triple weight measure Revised January 2021 All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation. Visitors to this page often check HEDIS FAQs, QRS FAQs, or ask a question through MyNCQA. <> HEDIS 2022 Percentile : HEDIS : Annual Dental Visit (Ages 2-20 years) 121,271 . from January to May for the prior year. The 90th percentile is the benchmark for the HEDIS measures. rFZ /CvN`(,b$CoyeL`Y6P-@ DL U `j@ +Y&F] S-ppo>8w4Dg`` C We do not share your information with third parties. ElectronicClinicalDataSystem(ECDS)Reporting. AdvanceCarePlanningIndicator. An official website of the United States government NCQAnowcollectsthenewAntibioticsforRespiratoryConditionsmeasure. 0000001386 00000 n Copyright 2023 National Committee for Quality Assurance. 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. CPT: 87070, 87071, 87081, 87430, 87650-87652, 87880 HEDIS Tip Sheet - Pediatric Measures Key HEDIS Factors to Consider 2527 0 obj <> endobj lock Copyright 2023 National Committee for Quality Assurance. Anticipated Release Date: September 2023. w !1AQaq"2B #3Rbr JFIF ` ` C Summary Table of Measures, Product Lines and Changes 1 HEDIS MY 2022, Volume 2 HEDIS VOLUME 2 MY 2022 . Thismeasurewillallowplanstounderstandifadvancecareplanningisprovidedtobeneficiarieswhoaremostlikelytobenefitfromit. %PDF-1.7 % 7 0 obj That makes HEDIS one of health cares most widely used performance improvement tools. Measurement Year 2020 UHCCP-RI 2022 CAHPS Measurement Year 2021 Quality Compass Measurement Year 2021 National Medicaid Benchmark (Met/Exceeded) Quality Compass Measurement Year 2021 National Medicaid Mean Rating of Health Plan1 86.6% 92.4% 86.8% 50th 86.48% Rating of All Health Care 95.0% 88.4% Small Sample Not Applicable 87.34% HEDIS Measures. . trailer 9 0 obj <> endstream endobj 30 0 obj <>stream 0000005676 00000 n Table 4 displays the HEDIS performance measures for MY 2021 for PCCP. Rate 2: Two additional well-child visits 15 to 30 months. The PA-specific indicators were added to include services with high utilization in the BH Program that could HC not be mapped to any of the standard coding used in the HEDIS measure to identify follow-up office visits. Initiation and Engagement of Substance Use Disorder Treatment; changed the measurefrommember-basedtoepisode-based; changed thedenominatortolengthenthenegativeSUDhistoryperiodfrom60daysto194daysandremoveEDvisitsandmedicallymanagedwithdrawalfromthenegativeSUDhistoryperiod;removed the numerator requirementthatpsychosocialtreatmentaccompanypharmacotherapy; and revisedtheagestratificationstoreflectages1864yearsand65+years.
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