HEDIS Quality Measures are important for health plans to keep track of. They are constantly being updated or changed, and 2017 is no different. The National Committee for Quality Assurance (NCQA) has just announced that there are new technical specifications for the 2017 edition of the performance improvement tool, HEDIS. The changes for 2017 will see four new measures, changes made to seven existing measures, and the removal of one measure.
New HEDIS Measures
Healthcare-Associated Infection Ratio (Standardized): This measure looks at publicly available data from the CDC’s National Healthcare Safety Network to gauge the potential infection exposure risk to members admitted to the health plan’s network hospitals. It is the first time that the NCQA is using facility-level healthcare-associated infection data through the NHSN, and this data represents hospital network safety.
Follow-Up After Emergency Department Visit for Mental Illness: This measure analyzes the percentage of Emergency Department (ED) visits for members 6 years old or older who have a principal diagnosis of mental illness, who then have a follow up visit for mental illness between 7 days and 30 days of the original ED visit.
Follow-Up After Emergency Department Visit for Alcohol and Other Drug Dependence: This measure looks at the percentage of Emergency Department visits for members 13 years old or older who have a principal diagnosis of alcohol or other drug dependence. It considers those who then have a subsequent follow-up visit for the same diagnosis between 7 days and 30 days of the Emergency Department visit.
Depression Remission or Response for Adolescents and Adults: This measure analyzes the percentage of members 12 years of age and older who were diagnosed with depression, who then have evidence of response or remission of their symptoms within 5 to 7 months after they show an elevated PHQ-9 score.
Updated HEDIS Measures
There are seven changes to the HEDIS Quality Measures for 2017. Changes have been made to the following measures:
- Potentially Harmful Drug-Disease Interactions in the Elderly
- Use of High-Risk Medications in the Elderly
- Potentially Harmful Drug-Disease Interactions
- Use of Imaging Studies for Low Back Pain
- Fall Risk Management
- Pneumococcal Vaccination Status for Older Adults
- Immunizations for Adolescents and Human Papillomavirus Vaccine for Female Adolescents
With value-based care reimbursement becoming more widely used, it is important to be aware of the current HEDIS quality measures. At Chart Review Nurses we have qualified, professional nurses on staff to take care of all of your HEDIS tasks.
What Chart Review Nurses Offers
At Chart Review Nurses, we offer a variety of services for health plan representatives. We can be as fully, or as little integrated in your HEDIS tasks as you require. Our nurses are highly qualified, experienced nurses that can meet your needs. They are trained to review, compile and analyze data that determines performance in 71 different categories. No matter the HEDIS task, the nurses at Chart Review Nurses can complete it.
If keeping up with changes in HEDIS quality measures and tasks is taking away from providing the best service to your clients, then call Chart Review Nurses today at (877) 328-2343! Our friendly, knowledgeable staff will be happy to discuss transitioning to become a part of our network.
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