This process ensures that HEDIS measures remain relevant and feasible for implementation. Official websites use .govA 2 Summary Table of Measures, Product Lines and Changes HEDIS MY 2023, Volume 2 HEDIS MY 2023 Measures Applicable to: Commercial Medicaid Medicare Changes for HEDIS MY 2023 Guidelines for Allowable Adjustments of HEDIS 9 9 9 x Updated Guideline 4: Exclusions to remove optional exclusions. To learn more. Intent:The 2019 American Geriatrics Society Beers Criteria recommendthat benzodiazepinesbeavoidedinolderadults. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. 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. 2527 0 obj <> endobj 0000051029 00000 n HEDIS Measure - Term for how each domain of care is further broken down. For more information regarding future quality measure consideration and selection, please visit Measure Selection | CMS MMS Hub. Follow-UpAfterEmergencyVisitDepartmentVisitforAlcoholandOtherDrugDependence/Follow-UpAfterEDVisitforSubstanceAbuse. S/K[ AOIp startxref ("$e 0)*[sNwL(((((()#(1/I\HlQ3F7n6 e#+}:~9'M]Fn*m(jfe Z)TRPQZWV+9F x_O. 0000002663 00000 n ( Technical specifications for the Health Outcomes Survey (HOS). Volume 2:Technical Specifications for HealthPlans. R'A@>r 5^[qLp.p*DB24V,mb66vA8kwFvM@gf` r NCQA's Risk Adjustment Tables (the "Tables") and any related documentation (collectively, the "Product"). We dont take HEDIS updates and changes lightly: Measure development and updates follow a rigorous process that includes a public comment period and input from advisory panels. 0000008673 00000 n NCQA screens, trains and certifies organizations that collect or audit data for health plans and providers. 0000013436 00000 n HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). %%EOF Every year,NCQA updates and releases the Healthcare Effectiveness Data and Information Set (HEDIS). Accountable health care requires both measurement and transparency. <> This process ensures that HEDIS measures remain relevant and feasible for implementation. rFZ /CvN`(,b$CoyeL`Y6P-@ !9g=SW[h ,3%`~,Z-"3b~lv?.cKQZLHJ*??Y$t)mvdQZt6F^_"g&Oa}t%&QZ./w|PCZE9vG2{m!miVv| Q@?\ti+3#{lgi Three of the four diabetes measures rate at the HEDIS digital future has begun. xKK@ { a;;:/DCXlcf_YB^Q(przeq0)# 0y,-h6-2Y=Vf]+[eq[&ge1heucd;)CzGE"z&D%z`SS?I1ZOFb ?=xb =WV!Nfvb)e:R '$t^OWoM9o{$)GlCeSkftDJbR2$n{Y4O}0m$&pmT|yQ;x/8Z$[G@MY?mcwo;oN:p2 4 0 obj REQUIRED HEDIS1 AND CAHPS2 MEASURES FOR HEDIS REPORTING YEAR 2022 Summary of Changes to Measure List: Added the following measures. 0 ]c\RbKSTQ C''Q6.6QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ T " hb``` rB cc`ahpb`QN`|A(WY2c0Oeox%{$M94 NSqo All other uses of the UB Codes require a license from the AHA. 0000014654 00000 n High-qualityhealthcaremustbeequitablehealthcare. 0000001035 00000 n 2 Technical Specifications Update, HEDIS 2020 (MY 2019) Risk Adjustment Tables, HEDIS 2020 Measure Trending Determinations, Quality Rating System 2020 Technical Specifications Update, Volume 3 2020 Technical Specifications Update, Volume 3 2020 Validated Member-Level File Layout, HEDIS MY 2023 Measure Trending Determinations, MY 2023 Validated Member-Level File Layout (, Order this publication (anticipated release date: May 2024). Ylyr2fi4vVDlhV]Zk:6d,,y+kQ. 0000017732 00000 n To learnmore, clickherefor a discussion ofthe stratification, how we arrived atthiscurrentpoint andFAQs. <> NCQArevisedthemeasurestructurefromutilizationtodiagnosed-prevalencementalhealthdisordersandupdatedthenameto. Specifications outline measure definition and details, which outline the specifications required to evaluate the recommended standards of quality for the element(s) in the measure. Ur"J,3Xhi"k;}06]rn(0i Copyright 2023 National Committee for Quality Assurance. The HEDIS measurement set is sponsored, supported and maintained by NCQA. performance reported in the 2022 Quality Compass (measurement year 2021) for all lines of business that reported measurement year 2021 . 6 0 obj 0000045019 00000 n ). Pn MS% 9W4=9Hu-]Sy+G'5} I!Orx*YtK5"Y"}w l_Zqypx -kind&gW%dj56u|x;cIInF7J^u$SqISS:th6 m%64SxllMjD(oh+z 0000017803 00000 n HEDISpublicationsareavailableas electronic publications. w !1AQaq"2B #3Rbr 0000004949 00000 n 0000047520 00000 n Anticipated Release Date: September 2023. UseofImagingStudiesforLowBackPain. 0000032016 00000 n 0000050943 00000 n Social Determinants: Our Statement with TJC, NQF Was Just the Start. 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 0000002321 00000 n To learn more, click here for a discussion of this new measure. 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: website belongs to an official government organization in the United States. 0000004562 00000 n 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 HEDIS MY2022. 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. A,0QV hXmTW3`IBH5@) ZmmP)pZA;H)Tt=lM"VPH`[[Z?j]MTz An official website of the United States government Immunization Schedules. Experience of Care. Formoreinformation,refertothefullmeasurespecificationsinHEDISMY2022. 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. This manual describes in detail only the NYS-specific measures. 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. 0000008747 00000 n Visitors to this page often checkHEDIS FAQsor ask a question throughMyNCQA. Save your favorite pages and receive notifications whenever theyre updated. You will be prompted to log in to your NCQA account. Save your favorite pages and receive notifications whenever theyre updated. endstream endobj startxref Visitors to this page often check HEDIS FAQs, QRS FAQs, or ask a question through My NCQA. 9 0 obj We do not share your information with third parties. m){w&;9l F*\JR4d87=dkh 0000015158 00000 n 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. endstream Rhode Island Medicaid Managed Care Page 48 of 69 2021 External Quality Review Technical Report . 51 0 obj <>stream NCQAisretiringthefollowingmeasures/indicators: Formoreinformation,refertothefullmeasurespecificationsinHEDISMY2022Volume 2:Technical Specifications for HealthPlans. 0000018438 00000 n NCQA defines how data can be collected for a measure: HEDIS/CAHPS Measures Required for HP AccreditationCommercial *The weight column indicates the weight of the item (maximum value = 3) in the overall score calculation. 0000005411 00000 n 1358 0 obj <>stream Quality Compass 2023 Commercial Premier Edition-Trended Data (MY 2022, MY 2021, MY 2020) with Data Exporter. 0000133309 00000 n P}^bGx{Q1F b~/>@ e# 0000008708 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). 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. HEDIS measures performance in health care where improvements can make a meaningful difference in peoples lives. 0000015786 00000 n (Example: COL, BCS measures). <> 0000004224 00000 n 0000009457 00000 n Effective 2022, the Promise VIP Program is now called Promise Quality Performance Incentive (PQPI). ElectronicClinicalDataSystem(ECDS)Reporting. 0000035489 00000 n 0000002169 00000 n 0 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 !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 QARR List of Required Measures (Table 1) lists by product the measures required for submission. 0000107074 00000 n endstream endobj 32 0 obj <>stream <> NCQA Communications Every year, NCQA updates and releases the Healthcare Effectiveness Data and Information Set (HEDIS). %%EOF 4920 0 obj <> endobj <> NCQA also revisedthedenominatortoreflectthenumberofmembers,ratherthanmemberyears, andtoincludementalhealthdisordercodesinanypositionratherthanbyprincipaldiagnosis.Recognizingthatmentalhealthdisordersmaybetreatedbyprimarycareandotherpractitioners,NCQAremovedthementalhealthpractitionerrequirementfromthenumerator. %%EOF 0000016920 00000 n HEDIS Measures for Diabetes are assessed to evaluate the effectiveness of the program. Rates for the HEDIS measures were compared to corresponding Medicaid percentiles; comparison results are provided in the tables. 0000036100 00000 n Intent:Advancecareplanningisassociatedwithimprovedqualityoflife,increasedprovidertrustanddecreasedhospitalization. Optum Managed Transplant Program. . HEDIS 2022 Percentile : HEDIS : Annual Dental Visit (Ages 2-20 years) 121,271 . Trackingantibioticprescribingforallacute respiratory conditionswillprovide context about a healthplansoverall antibiotic use when viewedwiththree HEDIS measures ofappropriate. Auditsprotect results validity and reliability. DL U `j@ +Y&F] S-ppo>8w4Dg`` C [ Additionally,NCQA invites you to join HEDIS Users Group forinside information on HEDIS development and future directions. HEDIS Measures HEDIS includes more than 90 measures across 6 domains of care: Effectiveness of Care. Advancecareplanningisassociatedwithimprovedqualityoflife,increasedprovidertrustanddecreasedhospitalization. t,f`$yF;zXytHo. ND-)8^r|\q=.Kx.!J"G8IE 0000009893 00000 n endobj 0000020276 00000 n 0000010320 00000 n The 90th percentile is the benchmark for the HEDIS measures. Updates on HEDIS Measures MY2022. New digital measures reduce the burden of reporting quality results. endobj m="=jVvyNc{ 0000035753 00000 n As low as $16,810.25. endstream endobj 27 0 obj <> endobj 28 0 obj <> endobj 29 0 obj <>stream For the numerator, NCQA allowed follow-up visits with SUD indicated in any diagnosis position; and added pharmacotherapy for alcohol or opioid use disorder; and incorporated outpatient or telehealth visits, for a diagnosis of drug use or overdose; services defined as addressing substance use (per CPT code description), without a diagnosis requirement; visits where a behavioral health assessment or screening is performed; outpatient or telehealth visits with a mental health provider; and substance use services provided by a peer recovery support specialis. hb```@(1iNlpiK Y_LjV_0`II:~|=0f8+~'8eW!Izw(I~>rIq9NM>8>N7*ksO6Qg4h%&. 0000008982 00000 n As low as $6,835.25. }{7wi\vLU#)J1i#} ;?0L1$Zh\D#$M},[Na_MxQ~+EYs}VgeWPL;hhWs, k>^c-sNWAOHKd3:o ThenewestadditionstoHEDISaddresspatient-centered care, as well assafetyand appropriateness. VA outpatient measures closely follow the specifications set forth by the National Committee for Quality Assurance (NCQA), Healthcare Effectiveness Data and Information Set (HEDIS). Share this page with a friend or colleague by Email. Visitors to this page often checkHEDIS FAQsor ask a question throughMyNCQA. 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. endobj 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). Visitors to this page often check HEDIS FAQs, QRS FAQs, or ask a question through MyNCQA. Share sensitive information only on official, secure websites. 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. 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. <> (7/1/prior yr. - 6/30/measurement year). Thismeasurehas beenretired. HEDIS MY 2022 Measures Applicable to: Commercial Medicaid Medicare Changes for HEDIS MY 2022 General Guidelines for Data Collection and Reporting CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). %PDF-1.4 % %PDF-1.7 0 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=[> **For Complaints about the Plan <<1EA954AB0783464B894F5E09E2AC546B>]/Prev 295107/XRefStm 1946>> Utilization and Risk Adjusted Utilization. means youve safely connected to the .gov website. Care for Children Prescribed ADHD Medication Initiation and Continuation measures. xref hbbd```b``"gIw ""7|-``qT3l0; fH0DHI@H_mj> _ Withthisdeprescribing measure, there isan opportunityto promote harm reduction by assessing progress in appropriately reducing benzodiazepine use in the older adult population. . NCQArevisedthemeasurestructurefromutilizationtodiagnosed-prevalenceofsubstanceuseandupdatedthenameto. 2 0 obj NCQA also revised themeasuredenominatortoreflectthenumberofmembers,ratherthanmemberyears, andtoincludesubstanceusedisordercodes; andrevisedtheagegroupsforreportingto1317,1864and65+. The Rules for Allowable Adjustments are included in the HEDIS Volume 2 publication after the applicable HEDIS measure specifications. 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. 0000004219 00000 n Women 30-64 years of age who had cervical high-risk human papillomavirus (hrHPV) B. Quantifiable Measures. Find Doctors, Drugs and Facilities. We do not share your information with third parties. endobj 65 years of age and older who were dispensed benzodiazepines and achieved a 20% decrease or greater in benzodiazepine dose during the measurement year. 5 0 obj The technical specifications for organizations providing Medicaid long-term services and supports (LTSS). HtTYO@~e/wysRx 0000133484 00000 n 0000011150 00000 n Health Plan Descriptive Information. Quality Compass 2023 Commercial-Trended Data (MY 2022, MY 2021, MY 2020) As low as $7,690.25. <> Share this page with a friend or colleague by Email. HEDIS survey measures and standardized surveys from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) program. 1CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). 0000002938 00000 n Patient-Centered Specialty Practice (PCSP), Credentials Verification Organization (CVO), Managed Behavioral Healthcare Organization (MBHO), Health Information Technology Prevalidation Programs, Virtual Seminars, Webinars and On-demand Training, Advertising and Marketing Your NCQA Status. Members can access the latest news about measuring performance and gain insight into how HEDIS evolves. Measures relate to many significant public health issues such as cancer, heart disease, behavioral health and diabetes. trailer Rate 1: Six or more well-child visits* 0 to 15 months. A list of potential measures for initial stratification in MY2022 are as follows: Controlling High Blood Pressure (CBP) Comprehensive Diabetes Care (CDC) Antidepressant Medication Management (AMM) Follow-Up After Emergency Department Visit for People with Multiple High-Risk Chronic Conditions (FMC) 0000007305 00000 n trailer <<41FE7AD153BB4900891AA2CB9A9A8E7D>]/Prev 786146/XRefStm 4224>> startxref 0 %%EOF 9780 0 obj <>stream 8 0 obj 0000001386 00000 n gbv[Dp[,tkg`h`PR``46R @0ft@ ublH$`@K WH@uX^$28C23n`Rbts&H-dpo]n0ch K$l7@ LD%@H00r'UvU h# ( 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. 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, HEDIS Measures. Most measure score changes between the 2022 and 2023 Star Ratings were small overall in both directions. 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. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S>> List and define all quantifiable measures used in this activity. The Data Display (D2) tool provides a way for patients to compare the quality of care hospitals give. % Table 7a: CHIP-MCO Results for 2022 (MY 2021) HEDIS Measures CHIP-MCO Include a goal or benchmark for each measure. 0000010141 00000 n HEDIS quality measures for Accountable Care Organizations. 7 0 obj 9745 0 obj <> endobj xref ThisclinicaltopicisnowaddressedinthenewAdvanceCarePlanningmeasure. This table contains the measures and brief descriptions that are included in HEDIS MY 2022. 0000012538 00000 n QI 1 and QI 2 utilize the HEDIS methodology for this measure. Advanced Care Planning. HEDIS nonsurvey measures for organizations; instructions on data collection for each measure; general guidelines for calculations and sampling. C*@ep!%E#-nb4LM AntibioticUtilizationforRespiratoryConditions. 0000010811 00000 n 4950 0 obj <>stream 0 0000021981 00000 n Wellcare dng cookie. 0000003369 00000 n Additionally,NCQA invites you to join HEDIS Users Group forinside information on HEDIS development and future directions. 1067 0 obj <> endobj 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. 0000009251 00000 n https:// DeprescribingofBenzodiazepinesinOlderAdults. 0000000016 00000 n 0000019234 00000 n Automatic . 0000010486 00000 n 0000006215 00000 n 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~ 0000007996 00000 n InitiationandEngagementofAlcoholandOtherDrugAbuseorDependence. 1311 0 obj <>stream Antibiotics prescribed for acute respiratory conditions are a large driver of antibiotic overuse. endobj We do not share your information with third parties. hWO`06~@)N@&d.6l5@[)"$$dm29R1$2.K3LH(y ]3SISTM}~/'Ys9Z @ R M+[|Qs0@!| T8E#F>x=-g? } !1AQa"q2#BR$3br The Cigna name, logos, and other Cigna marks are owned by Cigna Intellectual Property, Inc. 2021 Cigna INT_21_96354_C 919034 c 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. Thismeasurewillallowplanstounderstandifadvancecareplanningisprovidedtobeneficiarieswhoaremostlikelytobenefitfromit. 0000009785 00000 n endstream endobj startxref Table 4 displays the HEDIS performance measures for MY 2021 for PCCP. 0000010840 00000 n 0000001946 00000 n %%EOF MentalHealthUtilization/DiagnosedMentalHealthDisorders. 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. Copyright 2023 National Committee for Quality Assurance. 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% 0000022148 00000 n Plans must purchase the HEDIS 2022 Technical Specifications for Health Plans for specifications of the required HEDIS measures. NCQAalsorevisedthechildandadolescentagegroupsforreportingto117. 0000015971 00000 n 0000068208 00000 n 0000000016 00000 n andaddedtwocross-cuttingexclusions:palliativecareandadvancedillness/frailty. Data from the 2020 measurement period (2022 Star Ratings) help us understand how the PHE impacted the care delivery system. x Updated Guideline 7: Measurement Period Adjustments. Share this page with a friend or colleague by Email. 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 3 0 obj Two rates are reported. The information provided in this HEDIS QRG is to help you improve your practice's HEDIS rates. 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. CMS contracts with NCQA to collect Healthcare Effectiveness Data and Information Set (HEDIS) measures from Medicare Special Need Plans (SNPs). In these cases, age stratifications will differ from HEDIS MY 2021 technical specifications. 0000011142 00000 n from January to May for the prior year. 0 Quality Compass 2023 Medicaid-Trended Data (MY 2022, MY 2021) with Data Exporter. !(!0*21/*.-4;K@48G9-.BYBGNPTUT3? the HEDIS Measurement Year (MY) 2020 & 2021 Volume 2 Technical Speciications. lock Thismeasurewillallowplanstounderstandifadvancecareplanningisprovidedtobeneficiarieswhoaremostlikelytobenefitfromit. Island managed care plans must provide performance measure data, specifically HEDIS, to the Office of Health . II. HEDIS MY 2022 includes 96 measures across 6 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 Copyright 2023 National Committee for Quality Assurance. CPT: 87070, 87071, 87081, 87430, 87650-87652, 87880 HEDIS Tip Sheet - Pediatric Measures Key HEDIS Factors to Consider $4%&'()*56789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz ? 0000044978 00000 n Terms of Use, Every year,NCQA updates and releases the Healthcare Effectiveness Data and Information Set (HEDIS. 0000017889 00000 n endstream endobj 31 0 obj <>stream 42 0 obj <>/Filter/FlateDecode/ID[]/Index[26 26]/Info 25 0 R/Length 83/Prev 96543/Root 27 0 R/Size 52/Type/XRef/W[1 2 1]>>stream 2527 53 0000086512 00000 n 2022 MEDICAID HEDIS REFERENCE SHEET FOR PROVIDERS 3 PEDIATRIC HEDIS MEASURES HEDIS MEASURE AGE MEASURE DESCRIPTION BILLING CODES WELL-VISIT Well Child Visits 0-30 Months of Life (W30) 0-30 months Telehealth exclusion removed. 9745 36 HbA1c Testingindicator. HEDIS CHEAT SHEET 2022 - 2023 Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Documented yearly for ages 3-17. HEDIS Tip Sheet - Pediatric Measures -Look back period: July 1 of the year prior to June 30 of the measurement year. Measures Reported Using Electronic Clinical Data Systems HEDIS Medicare Health Outcomes Survey Anticipated Release Date: July 2023. HEDISpublicationsareavailableas electronic publications. This process ensures that HEDIS measures remain relevant and feasible for implementation. endobj 0000011393 00000 n {+Ed. Anticipated Release Date: September 2023. NCQAseparatedtheindicatorsintothreestandalonemeasures:HemoglobinA1cControlforPatientsWithDiabeteswith indictors for HbA1c Control <8 and Poor Control HbA1c >9,EyeExamPerformedforPatientsWithDiabetes,BloodPressureControlforPatientsWithDiabetes. Recognizing that HEDIS measures have traditionally been specified for health plan reporting, NCQA developed the Rules for Allowable Adjustment of HEDIS to accommodate the application of HEDIS measures to various levels of the health care system for quality improvement initiatives. Medicaid benchmarks displayed in these tables come from NCQA's 2022 Quality Compass for measurement year 2021. 0000011969 00000 n xPX]NG&)R.ng} (1$JMYpwV:] Quality Rating System Measure Technical Specifications are unique to the issuers offering plans on the Exchange and participating in the CMS Quality Rating System (QRS). Follow-UpAfterEDVisitforSubstanceUse. 0000004794 00000 n b~GiQ">sTMj 2p1IcvIwsudr 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 endobj performance reported in the 2022 Quality Compass (measurement year 2021) .

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