Quality Measures

HEDIS Made Easy: Your 2020 Technical Update

April 27, 2020

The CareMessage team knows that your work keeping up with measurement changes can be time consuming. We also know that staying on top of HEDIS updates is critical to the health of your FQHC. That’s why we’ve put together this quick overview of some of the most important points of the 2019-2020 HEDIS update along with a look into some coming changes for the next measurement year.

 

Key Info

  • The HEDIS 2020 Volume 2: Technical Update was formally announced on October 1, 2019.

  • The National Committee for Quality Assurance (NCQA) announcement letter is available here and contains the random number (RAND) table for HEDIS 2020 along with corrections, policy changes, and clarifications to HEDIS 2020 Volume 2.

  • This release freezes technical specifications for Volume 2 (except for measures that require pharmacy data and Risk Adjusted Utilization measures.)

  • This is only a guide and NCQA publications should be used as a primary source for all changes you are considering.

 

Background on Proposed Changes

 

These updates represent the final decision of the NCQA after considering comments from stakeholders including health plans, purchasers, and consumers. Some of the proposed changes included:

Retired Measures

  • Measures related to utilization of ambulatory care, general hospital and acute care (including maternity and survey services)

  • Osteoporosis testing in women ages 65-85 who report having received a bone mineral density test on their hip or back 

  • A measure related to assessing children and adolescents prescribed multiple antipsychotics concurrently (due to extremely low prevalence)

Newly Introduced Measures

  • Follow-up for patients who have received high-intensity care for substance use disorders

  • Pharmacotherapy for opioid use disorder (as research has shown that this type of therapy can improve opioid use disorder outcomes and is important in preventing relapse and overdose)

  • Prenatal and postpartum depression screening and followup for patients who have screened positive, along with updates to existing measures, including adherence to antipsychotic medications for patients with schizophrenia

Changed Measures

  • Structural changes to improve inappropriate prescriptions of antibiotics as well as cervical cancer screenings as a primary screening option

  • Prenatal and postpartum care, use of opioids at high doses, and use of high-risk medications on the elderly

Finalized 2020 Updates for Download 

The following updates are available for download:

 



Highlighted Changes for 2020

We recommend reviewing all release specifications and only making changes based on NCQA publications. But we would also like to highlight the following changes as potentially having the most impact on FQHCs. 

 

  • Childhood Immunization Status: Replace the second bullet with the following text (do not delete the dashed sub-bullets below the second bullet):

    • At least one measles and rubella vaccination (Measles Rubella Immunization Value Set; Measles Rubella Vaccine Procedure Value Set) on or between the child’s first and second birthdays and one of the following:

  • Comprehensive Diabetes Care:

    • HbA1c Poor Control >9%: Addition of two rows 

    • HbA1c Control <8%: Addition of 2 rows

    • HbA1c Poor Control <7% for a selected population: addition of 2 rows

  • Follow-Up After High-Intensity Care for Substance Use Disorder: removal of one row

  • Transitions of Care: addition of a sentence addressing documentation of provider awareness of member’s hospitalization or discharge

  • Use of High-Risk Medications in Older Adults: multiple changes

 

Changes that Impact Multiple Measures

The following changes impact multiple measures and should be reviewed closely.

 

  • Colorectal cancer screenings

  • Controlling high blood pressure

  • Persistence of beta-blocker treatment after heart attack

  • Comprehensive diabetes care



Looking Forward Toward HEDIS 2021

While the opportunity for public comment closed on December 20, it’s still worth staying ahead of potential updates for next years’ reporting period. 

 

The overview of proposed measure updates is available here, and proposed changes include:

 

  • Addition of Risk of Continued Opioid Use

  • Addition of CAHPS question addressing speed of receiving an appointment for a check-up or routine care at a doctor’s office or clinic

  • Retirement of Medical Assistance with Smoking and Tobacco Use Cessation

  • Retirement of CAHPS Getting Care Quickly composite

 

If you’re interested in adjusting your patient communications strategy to account for NCQA’s changes, fill out the form below and we’ll be happy to discuss how you can leverage text messaging to meet your 2020 HEDIS goals. 

 

 

Contact us using the form below.