That is why we publish what we learn from HEDIS in many forums and formats. Withthisdeprescribing measure, there isan opportunityto promote harm reduction by assessing progress in appropriately reducing benzodiazepine use in the older adult population. Anticipated Release Date: September 2023. [ 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. PDF HEDIS Benchmarks and Coding Guidelines for Quality Care 0000001386 00000 n . 0000006694 00000 n !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 startxref 2527 53 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. Wellcare dng cookie. Thismeasurewillallowplanstounderstandifadvancecareplanningisprovidedtobeneficiarieswhoaremostlikelytobenefitfromit. 0000008982 00000 n %PDF-1.4 % 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. reportingforthreeHEDISmeasures:Childhood Immunization Status, Immunizations for AdolescentsandMetabolic Monitoring for ChildrenandAdolescents on Antipsychotics. 1CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). 0000016906 00000 n |@Z-Q PDF Rhode Island Medicaid Managed Care Program Neighborhood Health Plan of PDF Commonwealth of Pennsylvania Department of Human Services Office of Two rates are reported. Formoreinformation,refertothefullmeasurespecificationsinHEDISMY2022. HEDIS MY 2022 Measures Applicable to: Commercial Medicaid Medicare Changes for HEDIS MY 2022 General Guidelines for Data Collection and Reporting <> 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. 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. 9745 0 obj <> endobj xref More than 200 million people are enrolled in plans that report HEDIS results. g'jQL[@tsho-0;F3a!~;F^MHFG"Y#HX@=<71AcL\oxdkw2& +i S/K[ AOIp 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. lock \\R4G_$g$T!7(9 HEDIS data help identify performance gaps and establish realistic targets for improvement. ,wBInd!d98{9|/.Y1&7wULt~s`GgvXT\/T}[_}bVT=TXk;e*ZkQXH#7hUxQ"zZdP> 6 0 obj AdvanceCarePlanningIndicator. lock NCQA also revisedthedenominatortoreflectthenumberofmembers,ratherthanmemberyears, andtoincludementalhealthdisordercodesinanypositionratherthanbyprincipaldiagnosis.Recognizingthatmentalhealthdisordersmaybetreatedbyprimarycareandotherpractitioners,NCQAremovedthementalhealthpractitionerrequirementfromthenumerator. This process ensures that HEDIS measures remain relevant and feasible for implementation. endstream 0000047520 00000 n Copyright 2023 National Committee for Quality Assurance. endstream endobj 31 0 obj <>stream DL U `j@ +Y&F] S-ppo>8w4Dg`` C PDF HEDIS Tip Sheet - Pediatric Measures - Sunshine Health 0000001946 00000 n Laboratory Benefit Management. PDF Rhode Island Medicaid Dental Program UnitedHealthcare Dental Annual HUG members are health care professionals who produce, report and interpret HEDIS data. <> %PDF-1.6 % Avoidance of Antibiotic Use. AntibioticUtilizationforRespiratoryConditions. 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) inappropriate prescribing for upper respiratory infections, pharyngitis and acute bronchitis. SUMMARY TABLE OF MEASURES, PRODUCT LINES AND CHANGES . TABLE 1: 2022 VBP LIST OF REQUIRED MEASURES - Required to Report NA - Not Applicable to the Arrangement Shading - Purple- Not required to be reported 1 - There are no reporting requirements for this measure. Data from the 2020 measurement period (2022 Star Ratings) help us understand how the PHE impacted the care delivery system. PDF Required HEDIS and CAHPS Measures for HEDIS Reporting Year 2022 HEDISpublicationsareavailableas electronic publications. Share this page with a friend or colleague by Email. 0000004224 00000 n Effective 2022, the Promise VIP Program is now called Promise Quality Performance Incentive (PQPI). 0000003808 00000 n 2022 Value Based Payment Reporting Requirements - New York State HbA1c Testingindicator. 0000010141 00000 n endobj 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. The information provided in this HEDIS QRG is to help you improve your practice's HEDIS rates. Social Determinants: Our Statement with TJC, NQF Was Just the Start. Part D measures are displayed in Tables 2 and 3 for MA-PD and PDP contracts, respectively. Intent:Advancecareplanningisassociatedwithimprovedqualityoflife,increasedprovidertrustanddecreasedhospitalization. Official websites use .govA 0000010811 00000 n 0000009785 00000 n HtTYO@~e/wysRx rFZ /CvN`(,b$CoyeL`Y6P-@ 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 VA outpatient measures closely follow the specifications set forth by the National Committee for Quality Assurance (NCQA), Healthcare Effectiveness Data and Information Set (HEDIS). Ur"J,3Xhi"k;}06]rn(0i NCQAseparatedtheindicatorsintothreestandalonemeasures:HemoglobinA1cControlforPatientsWithDiabeteswith indictors for HbA1c Control <8 and Poor Control HbA1c >9,EyeExamPerformedforPatientsWithDiabetes,BloodPressureControlforPatientsWithDiabetes. NCQA screens, trains and certifies organizations that collect or audit data for health plans and providers. 0000020276 00000 n cytology performed between 2020-2022. Advanced Care Planning. A,0QV Quality Compass 2023 Medicaid-Trended Data (MY 2022, MY 2021) As low as $5,220.25. Ylyr2fi4vVDlhV]Zk:6d,,y+kQ. 0000008747 00000 n Individual HEDIS Measures Sheets. {+Ed. 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. Encounter data is crucial for demonstrating accurate quality performance to the Department of Health Care Services (DHCS). PDF Rhode Island Medicaid Managed Care Program UnitedHealthcare Community Initiation and Engagement of Substance Use Disorder Treatment; changed the measurefrommember-basedtoepisode-based; changed thedenominatortolengthenthenegativeSUDhistoryperiodfrom60daysto194daysandremoveEDvisitsandmedicallymanagedwithdrawalfromthenegativeSUDhistoryperiod;removed the numerator requirementthatpsychosocialtreatmentaccompanypharmacotherapy; and revisedtheagestratificationstoreflectages1864yearsand65+years. HEDIS Measure PCCP Well-Child Visits First 15 Months 74.74% Well-Child Visits 1530 Months 81.79% HEDIS: General Guidelines and Measure Descriptions HEDIS 2022 Percentile : HEDIS : Annual Dental Visit (Ages 2-20 years) 121,271 . As low as $6,835.25. 0000022424 00000 n 0000009572 00000 n 0000002663 00000 n _hRos0Tx|1Ug% 0000010005 00000 n Summary Table of Measures, Product Lines and Changes 1 HEDIS MY 2022, Volume 2 HEDIS VOLUME 2 MY 2022 . This manual describes in detail only the NYS-specific measures. This process ensures that HEDIS measures remain relevant and feasible for implementation. This table contains the measures and brief descriptions that are included in HEDIS MY 2022. hbbd``b`$ $$zAm b1["A)@"|)k$@@Bv5#JQ' [@ 0000008644 00000 n Access/Availability of Care. 2527 0 obj <> endobj Rhode Island Medicaid Managed Care Page 48 of 69 2021 External Quality Review Technical Report . 0000016920 00000 n We do not share your information with third parties. To learnmore, clickherefor a discussion ofthe stratification, how we arrived atthiscurrentpoint andFAQs. PDF 2022-23 Health Plan Report Card - HEDIS Scoring Documentation We do not share your information with third parties. 1343 0 obj <>/Filter/FlateDecode/ID[<2D87A2A235A2694FB1EEAE97FC4AEC75>]/Index[1320 39]/Info 1319 0 R/Length 109/Prev 246119/Root 1321 0 R/Size 1359/Type/XRef/W[1 3 1]>>stream @_B^GR Save your favorite pages and receive notifications whenever theyre updated. NCQAwillconcentrateeffortsontheoutcome-basedHbA1cControlforPatientsWithDiabetesmeasure. NCQArevisedthemeasurestructurefromutilizationtodiagnosed-prevalenceofsubstanceuseandupdatedthenameto. D('@E$xVK`"P6 ?L dvC) ? 1 0 obj ( !9g=SW[h ,3%`~,Z-"3b~lv?.cKQZLHJ*??Y$t)mvdQZt6F^_"g&Oa}t%&QZ./w|PCZE9vG2{m!miVv| Q@?\ti+3#{lgi 0000029366 00000 n The Data Display (D2) tool provides a way for patients to compare the quality of care hospitals give. %%EOF R'A@>r 5^[qLp.p*DB24V,mb66vA8kwFvM@gf` r PDF 2022 Medicaid Hedis Reference Sheet for Providers 0000068208 00000 n 0000001035 00000 n MentalHealthUtilization/DiagnosedMentalHealthDisorders. PDF Commonwealth of Pennsylvania, Department of Human Services 2022 xKK@ { a;;:/DCXlcf_YB^Q(przeq0)# 0y,-h6-2Y=Vf]+[eq[&ge1heucd;)CzGE"z&D%z`SS?I1ZOFb ?=xb =WV!Nfvb)e:R '$t^OWoM9o{$)GlCeSkftDJbR2$n{Y4O}0m$&pmT|yQ;x/8Z$[G@MY?mcwo;oN:p2 <> endstream endobj 27 0 obj <> endobj 28 0 obj <> endobj 29 0 obj <>stream NCQA collects HEDIS data from health plans and other health care organizations. means youve safely connected to the .gov website. 0000017889 00000 n To learnmore, clickherefor a discussion ofthe stratification, how we arrived atthiscurrentpoint andFAQs. NCQAexpandedtheupperagelimitfrom50to75;addedreportingfortheMedicareproductline;addedfourclinicalexclusionsforosteoporosis. hbbd``b@Bf` $30`l/@ vzp`}jArJ;,-r1cb?>~XVU(pAi-Im kC#)}i^_ eMRNxz;e~FOL:epYMit *9(66a?`4 /[2u0@G5Q^+NDV&h$!~_sO {9oHp3N)I4BP5N1K0Up ]%x2P1xvk?7?]k'a stream 0000013436 00000 n PDF 2022 - HEDIS Quality Measures Reference Guide (version 1 04.11.2022) %%EOF InitiationandEngagementofAlcoholandOtherDrugAbuseorDependence. 0000008074 00000 n performance reported in the 2022 Quality Compass (measurement year 2021) for all lines of business that reported measurement year 2021 . 9745 36 G-3245 Beecher Road Flint, Michigan 48532 CPT: 87070, 87071, 87081, 87430, 87650-87652, 87880 HEDIS Tip Sheet - Pediatric Measures Key HEDIS Factors to Consider endstream endobj 30 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. HTn0*hk!4J[&5i7Y%I yf IdentificationofAlcoholandOtherDrugServices/DiagnosedSubstanceUseDisorders. C*@ep!%E#-nb4LM JFIF ` ` C %PDF-1.7 % 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. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. Care for Children Prescribed ADHD Medication Initiation and Continuation measures. You will be prompted to log in to your NCQA account. The technical specifications for organizations providing Medicaid long-term services and supports (LTSS). Table 4 displays the HEDIS performance measures for MY 2021 for PCCP. 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% 0000014654 00000 n 0000009251 00000 n 0000007996 00000 n * Measures from HEDIS and CAHPS used data from the 2020 Star Ratings (collected in 2019 and unaffected by the COVID-19 PHE). 5kET"gDka6FT@-hU \N!VGk}J.V29< Table 1: Changes in Part C Measure Scores from 2021 to 2023 Star Ratings for MA Contracts 0000035489 00000 n Advancecareplanningisassociatedwithimprovedqualityoflife,increasedprovidertrustanddecreasedhospitalization. By accessing the Product, the User is deemed to have accepted the terms and conditions of this Usage Agreement. 0 Outpatient Compare Data | Veterans Affairs <> 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. click here for a discussion of this new measure. ElectronicClinicalDataSystem(ECDS)Reporting. Utilization and Risk Adjusted Utilization. Several clinical guidelinesrecommend deprescribing benzodiazepinesslowlyandsafely, rather thanstopping use immediately,tominimizewithdrawalsymptomsandimprovepatientoutcomes. ("$e 0)*[sNwL(((((()#(1/I\HlQ3F7n6 e#+}:~9'M]Fn*m(jfe Z)TRPQZWV+9F x_O. ]c\RbKSTQ C''Q6.6QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ T " %PDF-1.7 Women 30-64 years of age who had cervical high-risk human papillomavirus (hrHPV) 0000002169 00000 n PDF Rhode Island Medicaid Managed Care Program Tufts Health Public Plan
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