The HEDIS measurement set includes over 70 quality indicators for commercial, Medicare, Special Needs Plan (SNP) and Medicaid reporting. Changes for HEDIS 2012 reporting are outlined below. For additional details on the revised measure specifications and general guidelines, see NCQA's HEDIS 2012 Summary Table or e-mail our HEDIS team at HEDIS@adventadvisorygroup.com.
New Measures
For HEDIS 2012 reporting, NCQA has added the following two new measures for commercial and Medicaid reporting. Since they are first-year measures, neither are eligible for public reporting by NCQA. However, individual states may opt to report organization-specific results.
- Human Papillomavirus Vaccine for Female Adolescents (HPV)
- Medication Management for People with Asthma (MMA)
Revised Measures
Modifications to individual HEDIS measures include the addition and deletion of codes, clarifications in definitions and revised wording. The following outlines overall changes to the HEDIS 2012 reporting set.
- Changed the Medicare submission deadline date to June 15.
- Introduced the Utilization and Relative Resource Use domain, which includes measures from the former Use of Services and Cost of Care domains.
- Renamed the former Satisfaction With Experience of Care domain to Experience of Care.
- Deleted V codes that identify an encounter or screening since they do not indicate that a service was performed.
- Implemented the proposed changes to the Relative Resource Use measures.
Retired Measures
Beginning with HEDIS 2012, the following measure has been retired from the HEDIS reporting set.
- Relative Resource Use for People with Acute Low Back Pain (RLB)
Measures Eligible for Rotation
Commercial and Medicaid organizations are eligible to rotate the following measures for HEDIS 2012 reporting.
- Controlling High Blood Pressure (CBP)
- Prenatal and Postpartum Care (PPC)
Medicaid plans are also eligible to rotate the following measures for HEDIS 2012 reporting.
- Cervical Cancer Screening (CCS)
- Frequency of Ongoing Prenatal Care (FPC)
- Weeks of Pregnancy at Time of Enrollment (WOP)
