NCQA’s Proposed Timeline for Retiring and Replacing HEDIS Hybrid Measures
November 15, 2024 · NCQA Communications
NCQA is collaborating with health care organizations across the industry to make HEDIS reporting fully digital by MY 2030. The evolution of HEDIS—and digital quality measurement, in general—leverages available electronic health data to make quality measurement more accurate, actionable, timely and affordable.
As we move toward a fully digital state, NCQA plans to phase out the hybrid method by MY 2029. Some hybrid measures will revert to an administrative-only method, while others will transition to being Electronic Clinical Data Systems (ECDS) measures.
“The hybrid method was introduced to enable retrieval of clinical information that was not available in administrative data,” says Tricia Elliott, Vice President of Quality Implementation at NCQA. “As the quality of electronic clinical data improves and the data become more accessible, our goal is to move all quality measures to ECDS and FHIR®/CQL digital quality measure formats.”
NCQA will seek feedback from industry stakeholders throughout the transition. Before measures transition, they will go through HEDIS public comment and must be approved by NCQA’s Committee on Performance Measurement.
Why Is NCQA Making This Change?
The goal of digital measure delivery is to reduce the burden of measurement. Historically, HEDIS measures have relied on administrative data, claims and retrospective data collection methods—including manual medical record review. Leveraging electronic health data can provide a timelier, more accurate portrait of quality.
ECDS reporting supports using electronic clinical data from diverse sources (e.g., clinical registries, electronic health records) to reduce the burden of medical record review. Four hybrid measures—Colorectal Cancer Screening, Cervical Cancer Screening, Childhood Immunization Status and Immunizations Status for Adolescents—are already transitioning to ECDS. These measures have parallel reporting options, allowing plans to compare ECDS results to traditional hybrid results for MY 2024 and MY 2025.
“We don’t anticipate a large impact on performance when the hybrid method goes away,” says Elliott. “The reliance on medical record review data varies by measure, but we have observed a smaller difference over time between the results based on digital data only and those that include medical record review.”
What Is Changing?
NCQA plans to transition away from the hybrid reporting method by MY 2029. When a hybrid measure shifts to ECDS or administrative specifications, the sampling methodology is removed and data are reported for the full population. Below is the transition plan for the eight HEDIS measures that will allow the hybrid reporting method in MY 2025.
MY 2026
- Lead Screening in Children (LSC)—Will be Administrative Only
MY 2027
- Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (WCC)—Will be Administrative Only
MY 2028
- Prenatal and Postpartum Care (PPC)—Will be Administrative Only
- Controlling High Blood Pressure (CBP)—Will transition to ECDS
- Blood Pressure Control for Patients with Diabetes (BPD)—Will transition to ECDS
MY 2029
- Glycemic Status Assessment for Patients with Diabetes (GSD)—Will transition to ECDS
- Transitions of Care (TRC)—Will transition to ECDS
- Care for Older Adults (COA)—Will transition to ECDS
For some measures, the ECDS measure will be introduced before removing the hybrid measure, allowing organizations to submit both versions as part of the transition.
What’s Next?
As health data standards and the secure exchange of health data improve, NCQA is developing digital quality measures for an increasing range of populations, treatments and health outcomes. Using more accurate, standardized data will help us measure what matters and will make measurement less burdensome.
“NCQA is designing HEDIS measures that can be used for additional purposes beyond comparing health plans,” says Elliott. “We are developing digital quality tools that improve the delivery and format of specifications and support population health managers and others seeking to improve quality and equity.”
Learn More About ECDS Measures
- Visit our ECDS webpage.
- Read the special report that summarizes the results for sixteen HEDIS measures that use the ECDS reporting standard.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
FHIR® is a registered trademark of Health Level Seven International and its use does not constitute endorsement by HL7.
