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No. The measure requires evidence of an advance care plan during the measurement year, dated during the measurement year. If the advance care plan is scanned into the EMR and dated in the measurement year, it meets criteria. If the plan is found in the EMR or member record from a prior year, it does not meet criteria unless there is dated evidence that it was reviewed or discussed during the measurement year.
HEDIS MY 2022
No. Medication reconciliations performed during a post-op/surgery follow-up visit alone do not meet criteria even if the visit was performed by the provider who admitted the member or who performed the surgery, or if the procedure is typically performed inpatient. The intent is that medical record documentation must support awareness of the hospitalization (denominator event) at the time of the medication reconciliation, even if the provider admitted the member or saw the member during the hospitalization, or if the procedure is typically performed inpatient.
HEDIS MY 2022
Yes. The reporting instructions for the initial population and exclusions data elements for ASF-E and DSF-E for MY 2022 and MY 2023 are incorrect. The reporting instructions should state, “For each stratification, repeat per metric” for the initial population and exclusions data elements. Refer to the PDF for the corrected data elements tables.
Note: The information is correct in IDSS (the validations check "For each stratification, repeat per metric” for the initial population and exclusions data elements).
**This FAQ applies to both HEDIS Volume 2 MY 2022 and HEDIS Volume 2 MY 2023
HEDIS MY 2022
The Statin Therapy for Patients With Cardiovascular Disease (SPC) and Statin Therapy for Patients With Diabetes (SPD) measures include an exclusion for members with myalgia, myositis, myopathy or rhabdomyolysis during the measurement year. However, an allergy or history of an intolerance to a statin medication is not considered an exclusion for the measure.
The general guidance NCQA received from our experts, as well as guidance from the American College of Cardiology , is that patients with atherosclerotic cardiovascular disease should be rechallenged on lower statin doses and alternative statins before being put on non-statin therapies (e.g., PCSK-9 inhibitors) due to statin intolerance. The decision-making process might vary from case to case. Although we incorporated exclusions for muscle-related statin side effects, we acknowledge that the measure may not address all instances of true statin intolerance. We will consider all feedback on this issue, while also ensuring that changes to the measure are valid, scientifically sound and true to the measure's intent (to measure the quality of cardiovascular care provided at the population level).
HEDIS MY 2022
The standard license agreement for Quality Compass allows internal or external reporting for 15 measure indicators, 20 health plan submissions and 2 benchmarks (averages and/or percentiles) outside of the users licensed on the account. If your organization’s expected data usage does not align with the standard agreement, we can review your requested permissions and draft a customized agreement, subject to a different fee structure.
HEDIS MY 2021
Quality Compass is NCQA’s interactive database containing individual plan performance results for HEDIS® and CAHPS® measures, as well as benchmark data at the national, regional (Census, HHS) and state levels. It reports individual plan data from plans that chose to publicly report their performance results. Benchmark results comprise all plan data submitted to NCQA, regardless of reporting status.
NCQA Health Plan Ratings (HPR) is a separate method of evaluating and distributing information related to health plan quality and performance. It assesses and reports plan performance in several domains. The goal of HPR is to give plans a scale to assess their current operating status, to help ensure quality. HPR provides consumers with information that helps them select a high-quality health plan that suits their needs.
NCQA’s Health Plan Ratings 2022 assesses commercial, Medicare, and Medicaid health plans. The overall rating is the weighted average of a plan’s HEDIS® and CAHPS® measure ratings, plus bonus points for plans with a current Accreditation status. Please visit our HPR website (https://www.ncqa.org/hedis/reports-and-research/ncqas-health-plan-ratings-2022/) to learn more.
HEDIS MY 2021
You can obtain access to performance data and benchmarks via the NCQA Quality Compass tool. Quality Compass is an interactive database containing individual plan performance results for HEDIS® and CAHPS® measures, as well as benchmark data at the national, regional (Census, HHS) and state levels. To learn more about Quality Compass and licensing access to HEDIS performance results, visit our Quality Compass homepage.
HEDIS MY 2022
You can contact the Information Products team for assistance in expanding your permissions to meet your data usage needs. This includes any changes to the amount of data being shared (number of indicators) and how/with who the data is being shared with (internally for quality analysis purposes, external reporting on a brochure, email broadcast, website, blog) or commercial use of the data.
HEDIS MY 2021
Only the measures whose results were eligible for public reporting are included in Quality Compass. Additionally, certain HEDIS measures are specific to certain product lines and do not have data across all product lines. Specific age and gender stratifications are only applicable to specific measures.
HEDIS MY 2021
