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The National Committee for Quality Assurance (NCQA) has released its HEDIS® 2018 Technical Specifications Update, closely tracked by health plans, auditors, and quality reporting and analytics vendors. Jenna Fitcher, product director for Verscend’s Quality Improvement solutions, breaks down the key takeaways.
the ant and the grasshopper:
getting a jump on HEDIS 2018
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Citing findings that the FPC measure is “complicated to collect” and doesn’t provide additional useful information beyond the existing Prenatal and Post-Partum Care measure, NCQA is retiring this measure for HEDIS 2018. This follows a new process that allows for the quicker retirement of HEDIS measures, as outlined recently on NCQA’s blog. The organization notes that it’s exploring better measurements related to maternal care, such as prenatal immunizations.
NCQA is removing the Medicare product line from the MPM measure, citing agreement among stakeholders that Medicare Advantage plans already exhibit relatively high performance. While it will remain in place for Medicaid and commercial plans, NCQA is retiring the digoxin indicator rate, noting experts’ input that the drug is rarely used. However, digoxin usage will still be monitored via the Use of High-Risk Medications in the Elderly measure.
One of seven new measures that NCQA introduced in July, FMC is aimed at ensuring that “people with multiple, high-risk chronic conditions receive prompt follow-up care after visiting the emergency department.” With the latest Technical Specifications Update, NCQA is clarifying the eligible population criteria. For example, members in hospice are excluded from the eligible population, and chronic conditions included in the measure should be diagnosed prior to the emergency department visit.
Another new measure for HEDIS 2018, NCQA introduced ASF to support monitoring of members who have had a systematic screening for unhealthy alcohol use as well as counseling or other follow-up care. NCQA is revising the measurement period (now January 1 through December 31 of the measurement year) as well as the age stratifications.
For HEDIS 2018, vendors need to have all measures collected using ECDS certified by the February 15 deadline for measure certification. Last year, this date did not apply for ECDS measures.
In short, HEDIS measurement and reporting vendors will have a total of eight additional measures to certify by February 15.
The HEDIS 2018 submission deadline is less than 250 days away. Looking for more insight to help you prepare? Register for our upcoming webinar on Wednesday, October 18. Listen and learn as quality improvement experts from Blue Cross and Blue Shield of North Carolina, Health First Health Plans, and Quartz Health Solutions share tips for managing their quality improvement projects to achieve their goals.