(4 Minute Read)
Since its inception in 1991, the Healthcare Effectiveness Data and Information Set (HEDIS®) has been widely used to ensure quality in managed care. HEDIS® is a comprehensive set of standardized performance measures that allows health plans to evaluate their performance against their counterparts, while also providing a means for employers and consumers to compare and select their plans.
More than 90% of health plans currently use HEDIS® to measure performance on important dimensions of care and service (NCQA). However, a significant challenge in ensuring high performance with HEDIS® is addressing and interpreting ever-changing technical specifications and implementing timely and effective action plans to address them.
HEDIS® includes more than 90 measures across 6 domains of care:
As the healthcare industry has changed, so has HEDIS® evolved and adapted, paving the way for easier data collection, more accurate measurement, and more timely results. With its continuing efforts to help health plans focus on quality care and respond to the challenges of COVID-19, NCQA has adopted sweeping changes to its HEDIS® measurement and reporting guidelines.
Impresiv Health's team of HEDIS experts have analyzed the changes coming for HEDIS 2021, and compiled this overview of the important changes that health plans should be aware of throughout the coming measurement year.
NEW MEASURES
Beginning with the Measurement Year 2020 and Measurement Year 2021 reporting cycle, plans will be required to include measurement of three new focus areas:
REVISED MEASURES
The Well-Child Visits metric, which was formerly limited to the first 15 months of life, has been extended to the first 30 months.
Palliative care exclusions are now required for several measures to ensure plans extend the most effective care to the patients who will benefit most, based on their conditions:
RETIRED MEASURES
For instance, the Disease-Modifying Anti-Rheumatic Drug Therapy for Rheumatoid Arthritis report is required in Measurement Year 2020, but not in Measurement Year 2021.
Other retired measurements include:
IMPORTANT HEDIS® DATES
Click HERE to view the full 2021 HEDIS submissions timeline
December 2020
March 31, 2021
May 2020
June 1, 2021
June 15, 2021
June 30, 2021
August 2021
September-October 2021
1 HEDIS® and Quality Compass® are registered trademarks of the National Committee for Quality Assurance (NCQA).
2 CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).
3 Quality Compass release dates are general time frames and are subject to change.
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