For reporting HAI for HEDIS 2017, NCQA defines a contracted acute care hospital as any acute care hospital to which the organization paid a claim for a member’s inpatient stay during the measurement period. This is a first-year measure; based on the results, NCQA may review this definition for changes in 2018.The FAQ posted in October regarding this topic was retracted given the release of the FAQ above.
HEDIS 2017
If it is standard practice to change diet or medications prior to a procedure, then exclude BPs on the same day as that procedure. For example, a colonoscopy requires a change in diet combined with bowel prep prior to the procedure. Therefore, BPs on the day of a colonoscopy are excluded even if the medical record documentation does not contain specific notation about a change in the member’s diet. Should organizations require support in identifying procedures where a diet or medication change is standard practice, they must consult with their internal clinical staff or their HEDIS auditor.
HEDIS 2017
If it is standard practice to change diet or medications prior to a procedure, then exclude BPs on the same day as that procedure. For example, a colonoscopy requires a change in diet combined with bowel prep prior to the procedure. Therefore, BPs on the day of a colonoscopy are excluded even if the medical record documentation does not contain specific notation about a change in the member’s diet. Should organizations require support in identifying procedures where a diet or medication change is standard practice, they must consult with their internal clinical staff or their HEDIS auditor.
HEDIS 2017
NCQA has been monitoring ACIP’s review of the HPV vaccination schedule. Once the recommendation is published in CDC’s Morbidity and Mortality Weekly Report, the appropriate NCQA staff and panels will evaluate potential changes to the measure.
HEDIS 2017 evaluates performance for calendar year 2016; measure specifications for HEDIS 2017 are final. Proposed changes, if any, will be posted for Public Comment in February 2017 and, pending final approval by the NCQA Committee on Performance Measurement, will be included in HEDIS 2018.
HEDIS 2017
Prior year’s validated historic hybrid medical record result files were removed from Section 5 (Supplemental Data) of the HEDIS Roadmap and are now listed as a data source used for reporting in Section 7 (Data Integration). Because of this change, these data should be loaded as administrative data, rather than as supplemental data, as in the past and should be considered administrative hits. This applies only to the previous year’s validated hybrid data, not to all medical record data or medical record data previously approved as supplemental data.
HEDIS 2017
Yes. Organizations may make this change to the CDC measure. On page 143, in step 1 of the Medical Record, organizations may delete the second and third bullets and add the following bullet:
NCQA allows organizations to make this change because it does not impact software programming for the measure. If an organization makes this change, it must do so consistently across all members.
HEDIS 2017
As stated in the measure guidance section for the DMS and DRR measures, include encounters where a diagnosis of major depression or dysthymia was addressed. The intent is to use encounters that are associated with managing depression to identify members in the Initial Population and to identify encounters to be included in the denominator calculation for Rate 2. In the HEDIS 2017 October Update, the Depression Encounter Value Set was renamed Interactive Outpatient Encounter Value Set, to clarify that it identifies outpatient encounters that can take place in a variety of settings. These encounters must be associated with a diagnosis of major depression or dysthymia in order to meet the intent of the measures.
HEDIS 2017
