HEDIS MY 2024: What’s New, What’s Changed, What’s Retired

August 1, 2023 · NCQA Communications

Every year, NCQA updates and releases measures in the Healthcare Effectiveness Data and Information Set (HEDIS^®). This process ensures that the measures remain relevant and feasible for implementation. We don’t take HEDIS updates and changes lightly: Measure development and major updates follow a rigorous process that includes a public comment period and input from experts and stakeholders.

For Measurement Year 2024, HEDIS retired four measures, updated the diabetes measures and made smaller changes across multiple measures. NCQA also continues the transition to Electronic Clinical Data Systems (ECDS) reporting.

Changes to Existing HEDIS Measures

• Glycemic Status Assessment for Patients With Diabetes. NCQA revised and renamed this measure (formerly Hemoglobin A1c Control for Patients With Diabetes) to include a glucose management indicator with hemoglobin A1c.
• Glycemic Status Assessment for Patients With Diabetes; Blood Pressure Control for Patients With Diabetes; Eye Exam for Patients With Diabetes; Kidney Health Evaluation for Patients With Diabetes; Statin Therapy for Patients With Diabetes; Diabetes Monitoring for People With Diabetes and Schizophrenia; Emergency Department Visits for Hypoglycemia in Older Adults With Diabetes. NCQA reassessed how these seven measures identify individuals with diabetes. The new method simplifies the specification and mitigates inclusion of individuals who take diabetes-related medications for reasons other than diabetes (e.g., weight loss) by adding a diabetes diagnosis requirement in the pharmacy method.

Cross-Cutting Topics

• Race/Ethnicity Stratification. NCQA introduced race and ethnicity stratifications to nine HEDIS measures: Follow-Up After Emergency Department Visit for Mental Illness; Follow-Up After Hospitalization for Mental Illness; Postpartum Depression Screening and Follow-Up; Prenatal Depression Screening and Follow-Up; Childhood Immunization Status; Cervical Cancer Screening; Prenatal Immunization Status; Kidney Health Evaluation for Patients With Diabetes; Eye Exam for Patients With Diabetes.

This effort builds on NCQA’s existing work to advance health equity. NCQA is committed to supporting the field as equity-centered data and measurement continue to evolve. To learn how we’re doing this, click here.

• Gender-Affirming Approaches to Measurement. To ensure that HEDIS measures appropriately acknowledge and affirm members’ gender identity, NCQA expanded the Breast Cancer Screening and Cervical Cancer Screening measures to include transgender members recommended for routine breast and cervical cancer screening.

NCQA plans to continue to explore opportunities to transform HEDIS measures to be inclusive and affirming of sexual and gender minority members.

ECDS Reporting

• NCQA retired the Administrative and Hybrid reporting methods for Colorectal Cancer Screening, Follow-Up Care for Children Prescribed ADHD Medication and Metabolic Monitoring for Children and Adolescents on Antipsychotics measures. Only the ECDS reporting method will be used for these measures.

Click here for information about the transition to ECDS reporting.

Retirement

NCQA is retiring the following measures in order to reduce burden, evolve HEDIS and enable health plans to direct resources toward improving collection of electronic clinical data:

• Use of Spirometry Testing in the Assessment and Diagnosis of COPD. The measure is not widely used and addresses only one aspect of COPD care (confirming a new diagnosis).
• Non-Recommended Cervical Cancer Screening in Adolescent Females. Recent HEDIS performance data indicate very little room for improvement at the health plan level.
• Ambulatory Care and Inpatient Utilization—General Hospital/Acute Care. Risk-adjusted utilization measures provide a better signal of quality; NCQA is exploring expanding these measures to include the Medicaid population.

For more information, refer to the full measure specifications in HEDIS MY 2024 Volume 2: Technical Specifications for Health Plans. HEDIS publications are available as electronic publications. NCQA invites you to join the HEDIS Users Group for an insider’s look at information on HEDIS development and future directions. To order publications, call 888-275-7585 or visit the NCQA Store.