No. Documentation of an “unknown” eye exam result does not meet criteria for hybrid reporting for the eye exam indicator of the CDC measure or the EED measure.
HEDIS MY 2021
FAQ Directory: HEDIS
Filter Results
11.15.2021 Comprehensive Diabetes Care If medical record documentation indicates that an eye exam result is “unknown,” does this qualify as a result when reporting the eye exam indicator of the CDC measure or the EED measure?
11.15.2021 General Guideline 18: Deceased Members How should we apply the “deceased members” exclusion in General Guideline 18: Deceased Members for episode-based measures?
The guideline for deceased members (General Guideline 18) is a member-level exclusion. For episode-based measures, if one event does not meet numerator criteria, and the organization chooses to use this optional exclusion, remove all member events/episodes from the measure.
HEDIS MY 2021
10.15.2021 General Guideline 32: Obtaining Information for the Systematic Sample Should the number of numerator events by administrative data in the eligible population (before exclusions), the number of required exclusions and the current year’s administrative rate (before exclusions) data elements change with a data refresh after the sample has been drawn?
10.15.2021 Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents The WCC measure includes a summary of change (SOC) to indicate that the value is stratified. Should this be removed from the SOC?
Yes. Remove the SOC that reads, “Revised the Reporting Instructions for the ‘NumeratorByAdminElig’ data element in Table WCC-1/2 to read ‘For each Metric and Stratification.’” Organizations reported “NumeratorByAdminElig” by age stratification in the past, so this is not a change to the measure for MY 2020 & MY 2021 reporting.
HEDIS MY 2022
10.15.2021 Transitions of Care The TRC measure includes a summary of change (SOC) to indicate that it the value is stratified. Should this be removed from the SOC?
Yes. Remove the SOC text that reads, “Revised the Reporting Instructions for the ‘NumeratorByAdminElig’ data element in Table TRC-3: Data Elements for Transitions of Care to ‘For each Metric and Stratification.’” Organizations reported “NumeratorByAdminElig” by age stratification in the past, so this is not a change to the measure for MY 2020 & MY 2021 reporting.
HEDIS MY 2022
10.15.2021 Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents The WCC measure includes a summary of change (SOC) to indicate that the value is stratified. Should this be removed from the SOC?
Yes. Remove the SOC that reads, “Revised the Reporting Instructions for the ‘NumeratorByAdminElig’ data element in Table WCC-1/2 to read ‘For each Metric and Stratification.’” Organizations reported “NumeratorByAdminElig” by age stratification in the past, so this is not a change to the measure for MY 2020 & MY 2021 reporting.
HEDIS MY 2021
10.15.2021 Transitions of Care The TRC measure includes a summary of change (SOC) to indicate that it the value is stratified. Should this be removed from the SOC?
Yes. Remove the SOC text that reads, “Revised the Reporting Instructions for the ‘NumeratorByAdminElig’ data element in Table TRC-3: Data Elements for Transitions of Care to ‘For each Metric and Stratification.’” Organizations reported “NumeratorByAdminElig” by age stratification in the past, so this is not a change to the measure for MY 2020 & MY 2021 reporting.
HEDIS MY 2021
10.15.2021 General Guideline 32: Obtaining Information for the Systematic Sample Should the number of numerator events by administrative data in the eligible population (before exclusions), the number of required exclusions and the current year’s administrative rate (before exclusions) data elements change with a data refresh after the sample has been drawn?
9.15.2021 PCS Questions Do answers from the Policy Clarification Support system have an expiration date?
9.15.2021 Guidelines for Calculations and Sampling: Hybrid Method How should the eligible population be reported for hybrid measures if there are optional or required exclusions?
The eligible population for hybrid measures should be reported before the optional exclusions and after the required exclusions for all three hybrid method approaches (refer to Appendix 4 in HEDIS Volume 2). For example, if the eligible population is 100 members and 10 members met optional exclusion criteria, then the reported eligible population value must still be 100.
HEDIS MY 2022
9.15.2021 General Guideline 33: Race and Ethnicity Stratification May supplemental data be used for race and ethnicity stratifications?
9.15.2021 Acute Hospital Utilization, Emergency Department Utilization and Hospitalization for Potentially Preventable Complications When should rounding occur for variance calculations?
The variance should not be rounded until the final step in the calculation. The final variance calculation for reporting should be rounded to four decimal places using the .5 rule. For example, the PPD and PUCD values are truncated to 10 decimal places, multiplied together at the member level and summed across members for the total. Round the total sum to four decimal places.
HEDIS MY 2021