ComprehensiveDiabetesCare/HemoglobinA1cControlforPatientsWithDiabetes,EyeExamPerformedforPatientsWithDiabetes,BloodPressureforPatientsWithDiabetes. from January to May for the prior year. HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). PDF HEDIS 2022 Manual 0000017732 00000 n PDF HEDIS Benchmarks and Coding Guidelines for Quality Care 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. xPX]NG&)R.ng} (1$JMYpwV:] 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. PDF Hedis Volume 2 My 2022 That makes HEDIS one of health cares most widely used performance improvement tools. endstream endobj 32 0 obj <>stream Measures Reported UsingElectronic Clinical Data Systems. Find Doctors, Drugs and Facilities. By accessing the Product, the User is deemed to have accepted the terms and conditions of this Usage Agreement. As low as $16,810.25. 0000021716 00000 n The percentage of episodes for members 3 months of age and older with a diagnosis of a respiratory condition that resulted in an antibiotic dispensing event. 74,457 : 61.4% : 61.1% : 61.7% : 55.9% + 60.5% + >= 90th percentile PA . Anticipated Release Date: July 2023. 0000008644 00000 n HSMk@WHM[Zl8 p ccwVrLCV{6GfP!Kh~&)/uY>ak9 endobj stream hbbd``b`$ $$zAm b1["A)@"|)k$@@Bv5#JQ' [@ }{7wi\vLU#)J1i#} ;?0L1$Zh\D#$M},[Na_MxQ~+EYs}VgeWPL;hhWs, k>^c-sNWAOHKd3:o A,0QV Utilization and Risk Adjusted Utilization. Copyright 2023 National Committee for Quality Assurance. 0000011150 00000 n PDF HEDIS Quick Reference Guide 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. endobj or ThiseffortbuildsonNCQAsexistingworkdedicatedtotheadvancinghealthequityindataandqualitymeasurement. MentalHealthUtilization/DiagnosedMentalHealthDisorders. 0000009685 00000 n %PDF-1.7 % [ https:// ThenewestadditionstoHEDISaddresspatient-centered care, as well assafetyand appropriateness. NCQA screens, trains and certifies organizations that collect or audit data for health plans and providers. QARR List of Required Measures (Table 1) lists by product the measures required for submission. endstream endobj 30 0 obj <>stream Quality Compass 2023 Medicaid-Trended Data (MY 2022, MY 2021) with Data Exporter. Follow-UpAfterEDVisitforSubstanceUse. %%EOF Quality Compass 2022 includes certain CAHPS data. ;(Y}e"XmT8,/l EP5ePVm8,&T2X, +|oM}> O~rEUnM~#jOicJ@2Yus hbbd``b@Bf` $30`l/@ 4950 0 obj <>stream Table 7a: CHIP-MCO Results for 2022 (MY 2021) HEDIS Measures CHIP-MCO High-qualityhealthcaremustbeequitablehealthcare. ElectronicClinicalDataSystem(ECDS)Reporting. Quality Compass 2023 Commercial-Trended Data (MY 2022, MY 2021, MY 2020) As low as $7,690.25. The complete MIPS Quality Measures List published after the PFS final rule does not include Qualified Clinical Data Registry (QCDR) measures as such measures are proposed and selected through a separate process. 2527 0 obj <> endobj 1{z>Y^1(|@jF{iPu~tPmu]1fGdBg8T]\;j/y=d[cug.HPVOIFf?,e?~Z.IieF;&QU;L.ltC9=Ah&Bo*Xn;al}tZF M&3#n$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. Follow-UpAfterEmergencyVisitDepartmentVisitforAlcoholandOtherDrugDependence/Follow-UpAfterEDVisitforSubstanceAbuse. 0000009785 00000 n 0000007305 00000 n 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. xref 4920 0 obj <> endobj 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). Ur"J,3Xhi"k;}06]rn(0i 0000001035 00000 n hbbd```b``akA$%Xd6dbe`X,,r, f_k0yDV[I vS _"A8^FO 0 E NCQArevisedthemeasurestructurefromutilizationtodiagnosed-prevalencementalhealthdisordersandupdatedthenameto. %%EOF .gov 9745 0 obj <> endobj xref Recognizing that HEDIS measures have traditionally been specified for health plan reporting, NCQA developed the Rules for Allowable Adjustment of HEDIS to accommodate the application of HEDIS measures to various levels of the health care system for quality improvement initiatives. MY 2002 was the yearfirst that follow-up rates were reported. We dont take HEDIS updates and changes lightly: Measure development and updates follow a rigorous process that includes a public comment period and input from advisory panels. 5 0 obj Rate 2: Two additional well-child visits 15 to 30 months. endstream endobj 4921 0 obj <. New digital measures reduce the burden of reporting quality results. m){w&;9l F*\JR4d87=dkh 0000010005 00000 n m="=jVvyNc{ 0000008747 00000 n endstream endobj startxref II . . PDF 2022 Medicaid Hedis Reference Sheet for Providers More than 200 million people are enrolled in plans that report HEDIS results. PDF Required HEDIS and CAHPS Measures for HEDIS Reporting Year 2022 PDF 2022-23 Health Plan Report Card - HEDIS Scoring Documentation HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). startxref HEDIS Diabetes Measures - Understanding Comprehensive Care o GRs_$ [EN=_sRs 1F/T ? Care for Children Prescribed ADHD Medication Initiation and Continuation measures. <> cytology performed between 2020-2022. P}^bGx{Q1F b~/>@ e# Thismeasurewillallowplanstounderstandifadvancecareplanningisprovidedtobeneficiarieswhoaremostlikelytobenefitfromit. 0 2023 HEDIS Measures HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). 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. B. Quantifiable Measures. Measure Changes Care for Older Adults (COA) - -Removed Advanced Care Planning indicator from COA . G-3245 Beecher Road Flint, Michigan 48532 Trackingantibioticprescribingforallacute respiratory conditionswillprovide context about a healthplansoverall antibiotic use when viewedwiththree HEDIS measures ofappropriate. HEDIS: General Guidelines and Measure Descriptions This process ensures that HEDIS measures remain relevant and feasible for implementation. PDF Rhode Island Medicaid Managed Care Program Neighborhood Health Plan of All other uses of the UB Codes require a license from the AHA. %&'()*456789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz To learn more, click here for a discussion of this new measure. Outpatient Compare Data | Veterans Affairs Three of the four diabetes measures rate at the NCQA collects HEDIS data from health plans and other health care organizations. PDF HEDIS SPECIFICATION OVERVIEW 2021 - Cigna REQUIRED HEDIS1 AND CAHPS2 MEASURES FOR HEDIS REPORTING YEAR 2022 Summary of Changes to Measure List: Added the following measures. 0000017803 00000 n Laboratory Benefit Management. Tobacco Cessation Program. Several clinical guidelinesrecommend deprescribing benzodiazepinesslowlyandsafely, rather thanstopping use immediately,tominimizewithdrawalsymptomsandimprovepatientoutcomes. 0 1CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). 0000133309 00000 n Sorry, this page could not be found. | Wellcare 0000003369 00000 n Encounter data is crucial for demonstrating accurate quality performance to the Department of Health Care Services (DHCS). UseofImagingStudiesforLowBackPain. ThisclinicaltopicisnowaddressedinthenewAdvanceCarePlanningmeasure. 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. The Healthcare Effectiveness Data and Information Set (HEDIS) is one of health cares most widely used performance improvement tools. Immunization Schedules. performance. Hedis - Ncqa 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. 0000004949 00000 n 0000005411 00000 n %PDF-1.6 % $4%&'()*56789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz ? HEDIS Tip Sheet - Pediatric Measures -Look back period: July 1 of the year prior to June 30 of the measurement year. Antibiotics prescribed for acute respiratory conditions are a large driver of antibiotic overuse. w !1AQaq"2B #3Rbr !A User may need additional software to use the Product, and NCQA is not responsible for such additional software. Healthcare Effectiveness Data and Information Set (HEDIS) 0000009572 00000 n Healthcare Efectiveness Data and Information Set (HEDIS ) rates can be calculated in two ways: administrative data or hybrid data. Copyright 2023 National Committee for Quality Assurance. We do not share your information with third parties. reportingforthreeHEDISmeasures:Childhood Immunization Status, Immunizations for AdolescentsandMetabolic Monitoring for ChildrenandAdolescents on Antipsychotics. 1343 0 obj <>/Filter/FlateDecode/ID[<2D87A2A235A2694FB1EEAE97FC4AEC75>]/Index[1320 39]/Info 1319 0 R/Length 109/Prev 246119/Root 1321 0 R/Size 1359/Type/XRef/W[1 3 1]>>stream PDF Hedis Cheat Sheet 2022 - 2023 Wellcare dng cookie. 0000018052 00000 n NCQAexpandedtheupperagelimitfrom50to75;addedreportingfortheMedicareproductline;addedfourclinicalexclusionsforosteoporosis. Women 30-64 years of age who had cervical high-risk human papillomavirus (hrHPV) You will be prompted to log in to your NCQA account. You will be prompted to log in to your NCQA account. Quality Rating System Measure Technical Specifications are unique to the issuers offering plans on the Exchange and participating in the CMS Quality Rating System (QRS). NYS will calculate the measure result for MY2021 2 - For measures that you may have reported using the hybrid sample in the PLD for QARR, 0000000016 00000 n 0000007331 00000 n D('@E$xVK`"P6 ?L dvC) ? Rate 1: Six or more well-child visits* 0 to 15 months. HEDIS/CAHPS Measures Required for HP AccreditationCommercial *The weight column indicates the weight of the item (maximum value = 3) in the overall score calculation. You will be prompted to log in to your NCQA account. HEDIS Measure - Term for how each domain of care is further broken down. 0000035753 00000 n 0000004562 00000 n ,wBInd!d98{9|/.Y1&7wULt~s`GgvXT\/T}[_}bVT=TXk;e*ZkQXH#7hUxQ"zZdP> Individual HEDIS Measures Sheets | Providers | Optima Health HEDIS Measures HEDIS includes more than 90 measures across 6 domains of care: Effectiveness of Care. andaddedtwocross-cuttingexclusions:palliativecareandadvancedillness/frailty. PDF 2023 HEDIS Measures - McLaren Health Plan Anticipated Release Date: September 2023. 0000004224 00000 n 4 0 obj Table 4: PCCP HEDIS Performance Measures - MY 2021 . SUMMARY TABLE OF MEASURES, PRODUCT LINES AND CHANGES . NCQArevisedthemeasurestructurefromutilizationtodiagnosed-prevalenceofsubstanceuseandupdatedthenameto. 0000008982 00000 n 0000050943 00000 n (7/1/prior yr. - 6/30/measurement year). Intent:Advancecareplanningisassociatedwithimprovedqualityoflife,increasedprovidertrustanddecreasedhospitalization. C*@ep!%E#-nb4LM CMS contracts with NCQA to collect Healthcare Effectiveness Data and Information Set (HEDIS) measures from Medicare Special Need Plans (SNPs). Terms of Use, Every year,NCQA updates and releases the Healthcare Effectiveness Data and Information Set (HEDIS. Effective 2022, the Promise VIP Program is now called Promise Quality Performance Incentive (PQPI). This process ensures that HEDIS measures remain relevant and feasible for implementation. 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: 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 %PDF-1.4 % Volume 2:Technical Specifications for HealthPlans. PDF 2022 - HEDIS Quality Measures Reference Guide (version 1 04.11.2022) endobj Share this page with a friend or colleague by Email. 0000000016 00000 n Accountable health care requires both measurement and transparency. 0000007450 00000 n Heres how you know. 2 0 obj NCQA's Risk Adjustment Tables (the "Tables") and any related documentation (collectively, the "Product"). X `q@ A`J~m ]l b| 0jHX=x3||DqGTt|\V~Fu3c,$;$c9 -Kd"bv.CXb%*qS-J`}V1h(l1y|8Tr46hOJ 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. 0000014293 00000 n 0000015786 00000 n HTn0*hk!4J[&5i7Y%I yf HEDIS 2022: See What's New, What's Changed and What's Retired 0000107074 00000 n To learnmore, clickherefor a discussion ofthe stratification, how we arrived atthiscurrentpoint andFAQs. Save your favorite pages and receive notifications whenever theyre updated. PDF 2023 Annual Call for Quality Measures Fact Sheet - Centers for Medicare Visitors to this page often checkHEDIS FAQsor ask a question throughMyNCQA. HEDIS nonsurvey measures for organizations; instructions on data collection for each measure; general guidelines for calculations and sampling. 0000051029 00000 n 0000011691 00000 n 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). VA outpatient measures closely follow the specifications set forth by the National Committee for Quality Assurance (NCQA), Healthcare Effectiveness Data and Information Set (HEDIS). That is why we publish what we learn from HEDIS in many forums and formats. 0000019234 00000 n 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. PDF HEDIS MY2022 Hybrid Measure Quick Guide 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. List and define all quantifiable measures used in this activity. |@Z-Q 0000001386 00000 n InitiationandEngagementofAlcoholandOtherDrugAbuseorDependence. CJ)8kPqQy!h\ADICp%F$NhG-EL'nU%mQ*1HPl. Utilization and Risk Adjusted Utilization. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. 26 0 obj <> endobj 0000008673 00000 n 0000010840 00000 n Patient-Centered Specialty Practice (PCSP), Credentials Verification Organization (CVO), Managed Behavioral Healthcare Organization (MBHO), Health Information Technology Prevalidation Programs, Virtual Seminars, Webinars and On-demand Training, Advertising and Marketing Your NCQA Status. performance reported in the 2022 Quality Compass (measurement year 2021) . Two rates are reported. the HEDIS Measurement Year (MY) 2020 & 2021 Volume 2 Technical Speciications. !(!0*21/*.-4;K@48G9-.BYBGNPTUT3? QLeRQ~{?$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 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. Island managed care plans must provide performance measure data, specifically HEDIS, to the Office of Health . 1067 0 obj <> endobj 9 0 obj trailer <<41FE7AD153BB4900891AA2CB9A9A8E7D>]/Prev 786146/XRefStm 4224>> startxref 0 %%EOF 9780 0 obj <>stream click here for a discussion of this new measure. To be able to identify andreduce disparitiesin care, the first step must be measuring and reportingon. R'A@>r 5^[qLp.p*DB24V,mb66vA8kwFvM@gf` r 0000018438 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. ( This table contains the measures and brief descriptions that are included in HEDIS MY 2022. 0000009457 00000 n endstream trailer Sign up to get the latest information about your choice of CMS topics. The Data Display (D2) tool provides a way for patients to compare the quality of care hospitals give. Advanced Care Planning. 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. 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. AdvanceCarePlanningIndicator. 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 31 0 obj <>stream !9g=SW[h ,3%`~,Z-"3b~lv?.cKQZLHJ*??Y$t)mvdQZt6F^_"g&Oa}t%&QZ./w|PCZE9vG2{m!miVv| Q@?\ti+3#{lgi 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% performance reported in the 2022 Quality Compass (measurement year 2021) for all lines of business that reported measurement year 2021 . rFZ /CvN`(,b$CoyeL`Y6P-@ Save your favorite pages and receive notifications whenever theyre updated. 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~ 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 <> 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). 0 hb``` rB cc`ahpb`QN`|A(WY2c0Oeox%{$M94 NSqo AntibioticUtilizationforRespiratoryConditions. 0000022148 00000 n x Updated Guideline 7: Measurement Period Adjustments. Share this page with a friend or colleague by Email. NCQAalsorevisedthechildandadolescentagegroupsforreportingto117. Auditsprotect results validity and reliability.

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