- NCQA is seeking public comment on planned changes to the Healthcare Effectiveness Data and Information Set (HEDIS) measures, including the HEDIS CAHPS survey.
Specifically, NCQA seeks comment on changes in the following areas:
- Retiring five measures.
- Shortening the HEDIS Health Plan CAHPS®2 (CAHPS 5.0H) Survey.
- New HEDIS measures assessing substance use disorder and prenatal and postpartum depression care.
- Revisions to several measures.
- Proposed changes that apply across multiple measures.
HEDIS measures are used to assess patient experience and care quality, the agency explained. NCQA reevaluates and revises HEDIS measures whenever new evidence or regulatory changes emerge in order to keep these measures up to date, the Committee said.
NCQA is specifically looking to shorten the HEDIS Health Plan CAHPS (Consumer Assessment of Healthcare Processes and Systems), a key patient satisfaction and experience measure. The Committee proposed removing four questions from the survey because those questions have proven to have low reliability, NCQA explained.
The Committee also proposed cutting five existing measures, including the following:
- Utilization of ambulatory care
- Inpatient utilization – General hospital/acute care
- Disease-Modifying Anti-Rheumatic Drug Therapy for Rheumatoid Arthritis
- Osteoporosis Testing in Older Women
- Use of Multiple Concurrent Antipsychotics in Children and Adolescents
The rationales for retiring those measures range from them being duplicative to raising reliability concerns, NCQA said.
NCQA also plans to implement the following new measures:
- Follow-Up After High Intensity Care for Substance Use Disorder
- Pharmacotherapy for Opioid Use Disorder
- Prenatal Depression Screening and Follow-Up:
- Postpartum Depression Screening and Follow-Up
Most of these measures would look at mental health and opioid use disorder treatment and follow-up care, ensuring patients have adequate access to care and are engaged in care following clinic or hospital discharge.
Other patient-facing changes to HEDIS measures include measures that would look at medication adherence in patients with schizophrenia, the use of antibiotics to treat viral infections, assessments of functional status in older adults, cervical cancer screenings and preventive care, and osteoporosis management in high-risk patients who have experienced a fracture.
The public comment period is an essential part of updating the HEDIS measures, NCQA explained.
“NCQA convenes multi-stakeholder advisory groups—including independent scientists, clinicians, consumers and purchasers—to ensure that measures meet and balance the high standards of relevance, scientific soundness and feasibility,” the Committee said in a public statement.
“Public review and comment is an important part of developing, updating and retiring HEDIS measures. NCQA reviews all comments received during public comment and presents results to multi-stakeholder advisory groups and the NCQA Committee on Performance Measurement for deliberation.”
The public comment period will be open for one month, from February 11, 2019, until March 11, 2019. Relevant parties may submit comments digitally only.
HEDIS includes over 90 measures geared toward ensuring a positive healthcare experience for patients, according to NCQA.
Operating under six domains – effectiveness of care, access and availability of care, experience of care, utilization and risk adjusted utilization, health plan descriptive information, and measures collected using electronic clinical data systems – HEDIS measures serve as a guideline by which NCQA awards certain certifications of excellence.
HEDIS measures are not a clinical guideline and should not be used determine insurance or coverage, NCQA says on its website.