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HEDIS® MY 2024 Updates

Date: 06/25/24

The National Committee for Quality Assurance (NCQA) updates Quality of Care and HEDIS guidelines annually. Below you will find the updated guidelines for HEDIS Measurement Year 2024. Please take a moment and review the following changes.

New Measures

  • There are no new measures for HEDIS MY 2024.

 

Retired Measures

  • Colorectal Cancer Screening (COL)*
  • Use of Spirometry Testing in the Assessment and Diagnosis of COPD (SPR)
  • Follow-Up Care for Children Prescribed ADHD Medication (ADD)*
  • Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM)*
  • Non-Recommended Cervical Cancer Screening in Adolescent Females (NCS)
  • Ambulatory Care (AMB)
  • Inpatient Utilization — General Hospital/Acute Care (IPU)

*Only the COL-E, ADD-E, and APM-E measures will be reported.

 

Revised Measures

  • The former Hemoglobin A1c (HbA1c) Control for Patients With Diabetes (HBD) measure was revised to Glycemic Status Assessment for Patients With Diabetes (GSD). See below for more details.
  • Glycemic Status Assessment for Patients With Diabetes (GSD)
    • Members 18–75 years of age with diabetes (types 1 and 2) whose most recent glycemic status (HbA1c or glucose management indicator (GMI)) was at the following levels during the measurement year:
      • Glycemic Status < 8.0%
      • Glycemic Status > 9.0%
    • The member is not numerator compliant if the result of the most recent glycemic status assessment is ≥ 8.0% or is missing a result, or if a glycemic status assessment was not done during the measurement year. If there are multiple glycemic status assessments on the same date of service, use the lowest result.
    • Identify the most recent glycemic status assessment (HbA1c or GMI) by utilizing the following codes during the measurement year:
      • LOINC code: 97506-0
      • CPT II code(s): 3044F, 3046F, 3051F, 3052F

As we move toward the future of reporting measures using Electronic Clinical Data Systems (ECDS), it will be important to remember the following:

  • HEDIS quality measures reported using ECDS inspire innovative use of electronic clinical data to document quality patient care that demonstrates commitment to evidence-based practices. Organizations that report HEDIS using ECDS encourage exchange of the information needed to provide quality services, ensuring that the information reaches the right people at the right time.
  • The ECDS reporting standard represents a step forward in adapting HEDIS to accommodate the expansive information available in electronic clinical datasets used for patient care and quality improvement.
  • ECDS are the network of data containing a plan member’s personal health information (PHI) and records of their experiences within the healthcare system. They may also support other care-related activities directly or indirectly, including evidence-based decision support, quality management, and outcome reporting. Data in these systems are structured such that automated quality measurement queries can be consistently and reliably executed, providing results quickly and efficiently to the team responsible for the care of health plan members.
  • Health plans that establish an enterprise network of interoperable electronic data systems will foster a member-centered, team-based approach to improving healthcare quality and better communication across healthcare service providers. Visit www.ncqa.org/ecds for more information and FAQs about ECDS reporting.*

*HEDIS Measurement Year 2024, Volume 2 Technical Specifications; www.ncqa.org/ecds

 

Measures Reported Using Electronic Clinical Data Systems (ECDS)

  • Childhood Immunization Status (CIS-E)
  • Immunizations for Adolescents (IMA-E)
  • Breast Cancer Screening (BCS-E)
  • Cervical Cancer Screening (CCS-E)
  • Colorectal Cancer Screening (COL-E)
  • Follow-Up Care for Children Prescribed ADHD Medication (ADD-E)
  • Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM-E)
  • Depression Screening and Follow-Up for Adolescents and Adults (DSF-E)
  • Adult Immunization Status (AIS-E)
  • Prenatal Immunization Status (PRS-E)
  • Prenatal Depression Screening and Follow-Up (PND-E)
  • Postpartum Depression Screening and Follow-Up (PDS-E)
  • Social Need Screening and Intervention (SNS-E)

If you have any questions or concerns about these updates, please contact our Quality Improvement HEDIS team at QI_AR_HEDIS@centene.com.