The HEDIS measurement set includes more than 70 quality indicators for commercial, Medicare, Special Needs Plan (SNP) and Medicaid reporting. Changes for HEDIS 2010 reporting are outlined below. For additional details on the revised measure specifications and general guidelines, see NCQA's HEDIS 2010 Summary Table and HEDIS 2010 Volume 2: Technical Update or e-mail our HEDIS team at HEDIS@adventadvisorygroup.com.
HEDIS 2010 Measure Changes
Modifications to individual HEDIS measures include the addition and deletion of codes, clarifications in definitions and revised wording. The following represent more significant changes that will likely impact HEDIS 2010 production processes, eligible populations and/or final rates.
- Introduction of the Immunizations for Adolescents measure
- Addition of hepatitis A, rotavirus and influenza vaccines to Childhood Immunization Status
- Modifications to the Colorectal Cancer Screening, Use of Appropriate Medications for People with Asthma, and Appropriate Treatment for Children with URI measures
- Removal of the hybrid methodology for Cervical Cancer Screening and the three well-child measures for commercial plans only
- Inclusion of only MS-DRGs for all measures that require DRGs (CMS-DRGs have been removed from the specifications)
- Separate reporting of outpatient and inpatient costs for the Relative Resource Use (RRU) Surgery and Procedure and E&M categories
- Retirement of the "Years in Business" component of Years in Business/Total Membership
Measures Eligible for Rotation
Commercial HMO/POS and Medicaid plans are eligible to rotate the following measures for HEDIS 2010 reporting.
- Controlling High Blood Pressure
- Prenatal and Postpartum Care
- Frequency of Ongoing Prenatal Care
- Week of Pregnancy at Time of Enrollment
- Cervical Cancer Screening
- CAHPS Health Plan Survey, Child Version
- Children With Chronic Conditions
Commercial plans are not eligible to rotate the Cervical Cancer Screening measure since it is no longer a hybrid measure for commercial reporting.
Public Reporting of HEDIS 2009 First-Year Measures
For HEDIS 2010, NCQA has approved for public reporting the following measures.
- Adult BMI Assessment
- Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
- Care for Older Adults
- Comprehensive Diabetes Care: HbA1c <8.0% and <7.0%
Medication Reconciliation Post-Discharge (MRP) was not included on the list of measures that will be publicly reported this year.
Public Reporting of Five Relative Resource Use Measures
In addition to the measures listed above, NCQA has approved the following Relative Resource Use measures for public reporting.
- RRU for People with Diabetes
- RRU for People with Asthma
- RRU for People with Cardiovascular Conditions
- RRU for People with Hypertension
- RRU for People with COPD
Public reporting of the RRU for People with Low Back Pain (RLB) measure has been temporarily suspended.
Expansion of Hybrid Method to PPO Plans
Beginning with HEDIS 2010, PPO plans will be eligible to conduct medical record review for all hybrid measures, except Colorectal Cancer Screening. The expansion of the hybrid method to PPO plans will impact Health Plan Accreditation 2010 scoring.
Modifications to the CAHPS Adult Survey
For HEDIS 2010 reporting, the CAHPS Health Plan Survey will include additional questions for the new Aspirin Use and Discussion measure. Also, the Smoking Cessation measure has been revised and renamed to specifically include tobacco use.
