Wednesday, March 22, 2017

Overview of HEDIS

How HEDIS Is Developed 
NCQA’s Committee on Performance Measurement (CPM), which includes representation from purchasers, consumers, health plans, health care providers and policy makers, oversees the evolution of the measurement set. Multiple Measurement Advisory Panels (MAP) provide clinical and technical knowledge required to develop the measures. Additional HEDIS Expert Panels and the Technical Measurement Advisory Panel (TMAP) provide invaluable assistance by identifying methodological issues and providing feedback on new and existing measures. 

2017 QARR (Quality Assurance Reporting Requirements) consists of measures from the National Committee for Quality Assurance’s (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS®), Center for Medicare and Medicaid Services (CMS) QRS Technical Specifications, and New York State-specific measures. 2017 QARR incorporates measures from HEDIS® 2017. The major areas of performance included in the 2017 QARR are: 

1) Effectiveness of Care – CIS, CDC, LSC, BCS 
2) Access to/Availability of Care – PPC, ADV 
3) Satisfaction with the Experience of Care - CAHPS 
4) Use of Services -Utilization and Relative Resource Use – FPC, FSP, AWC 
5) Health Plan Descriptive Information - BCR, LDM, RDM 
6) NYS-specific measures (Adolescent Preventive Care, Viral Load Suppression, and Prenatal Care measures from the Live Birth file)  

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