December 21, 2017
The National Committee for Quality Assurance (NCQA) recently announced the 2018 updates to the Healthcare Effectiveness Data and Information Set (HEDIS). HEDIS is a tool used by more than 90 percent of America's health plans to measure performance on important dimensions of care and service.
The HEDIS updates for 2018 include:
- Seven new measures
- Changes to four existing measures
- Two cross-cutting topics
The newest additions to HEDIS address emerging health needs and evolving processes in care delivery. Here are brief descriptions of two of the new measures:
- (UOD) Use of Opioids at High Dosage. This measure assesses the rate of health plan customers 18 years and older who receive long-term opioids at high dosage (average morphine equivalent dose >120mg).
- (UOP) Use of Opioids from Multiple Providers. This measure assesses the rate of health plan customers 18 years and older who receive opioids from multiple prescribers and multiple pharmacies. Intent: High dosage and involvement with multiple prescribers and pharmacies are risk factors for dangerous overdose and death. These measures add health plans to the group of stakeholders currently addressing the opioid epidemic.
- (FMC) Follow-Up after Emergency Department Visit for People with High-Risk Multiple Chronic Conditions. This measure assesses the percentage of ED visits for Medicare customers 18 years and older with high-risk multiple chronic conditions and follow-up care within 7 days of the ED visit. Intent: The purpose of this new measure is to improve the coordination of care for Medicare beneficiaries with multiple chronic conditions who are sent home from the Emergency Room. This follow-up should ensure better coordination of diagnoses, medications, and follow-up needs.
Read about all seven of the new measures and the additional changes for HEDIS 2018 outlined above.
For more information and/or questions regarding the article above, email ProviderEngagementTeam@premera.com.