FAQ Directory: HEDIS

Yes. Use the race/ethnicity value sets and direct reference codes in Tables RES-C-1/2/3 and RES-D-1/2/3 (in General Guideline 31) to report the RDM measure. This clarification will be in the MY 2023 Technical Update.

HEDIS MY 2023

Customers interested in accessing prior year data can choose to add up to three years of trended results to their Quality Compass purchase. For example, if you purchase Quality Compass 2022 (MY 2021), you can choose to add the trended data feature to access MY 2020 MY 2019 results.

It is important to note that not all data can be trended due to significant changes in the measure specifications. Quality Compass indicates when measures should be trended with caution or if there has been a break in trending and results should not be trended year-to-year. These trending determinations can be found on the Help tab within the Quality Compass tool or in the Volume 2 HEDIS technical specifications.

Access to the latest data year must be purchased annually.
 

HEDIS MY 2021

Currently each license is separated and there is no way to compare Commercial, Medicaid and Medicare in the same license. However, with the Data Exporter function, you will be able to pull reports in Microsoft Excel and that can make data comparison easier.
 

HEDIS MY 2021

Purchase order numbers may be included for payment and tracking purposes; however, NCQA does not accept additional terms and conditions outside the executed legal agreement. Any and all purchase order terms and conditions have no legal effect and the license is governed solely by the terms of the executed agreement between your entity and NCQA.
 

HEDIS MY 2021

All versions of Quality Compass allow users to build customized reports within the tool. Versions of Quality Compass that include the Data Exporter feature allows users to download and export those custom reports into Microsoft Excel.

The Data Exporter feature also grants access to the “All Measures Download” file. This file contains plan-level performance data for all publicly reported health plan submissions and all HEDIS and CAHPS measure results in a single downloadable file. Versions purchased without Data Exporter will not have the ability to export plan level data but will still have access to Excel versions of the benchmarks.
 

HEDIS MY 2022

Individual plan data are the HEDIS and CAHPS performance rates submitted by health plans that chose to publicly report their results to NCQA. Users have access to all publicly reported plans in a specific product line (commercial, Medicaid, Medicare) and can easily select a subset of plans based on coverage in different regions/states.
 

HEDIS MY 2022

Yes. The cell should be highlighted to indicate that it is calculated by IDSS.

HEDIS MY 2022

Deduplicate denominator episodes to one per day. Two eligible SUD encounters on the same date of service count as one denominator episode.  

HEDIS MY 2022

Yes. If validated DAV streams are used, they should be categorized as HIE/clinical registry data sources.

HEDIS MY 2021

Yes. If validated DAV streams are used, they should be categorized as HIE/clinical registry data sources.

HEDIS MY 2022

Administrative data, codes in the Absence of Cervix Diagnosis Value Set (e.g., ICD-10-CM Diagnosis code Q51.5 [agenesis and aplasia of cervix]) may be used to exclude transgender members from the measure. If the medical record documents that the member was born male (e.g., transgender male to female), this is evidence that the member does not have a cervix, meets optional exclusion criteria and may be removed from the measure. Medical record documentation of cervical agenesis or clinical synonyms (e.g., evidence a patient was born without a cervix) may also be used to exclude these members. These members should remain in the measure if the organization is unable to find the appropriate documentation.

HEDIS MY 2021

For measures with stratifications, use the total rate when reducing sample sizes. For measures with multiple indicators and stratifications, use the lowest total rate across indicators when reducing sample sizes.

HEDIS MY 2021