HEDIS 2016 Volume 2 and ICD-10 have both arrived. The NCQA announced on September 29, 2015 that the 2nd volume of HEDIS 2016 (The Healthcare Effectiveness Data and Information Set) would be completely ICD-10 compliant and ready for the implementation day of OCT 1. The NCQA has phased out the ICD-9 codes as per NCQA regulations and added over 73,000 ICD-10 codes, across 56 HEDIS measures. “Health plans, health data clearinghouses and health care providers will now be able to code records to comply with CMS requirements for HEDIS reporting.“
What is HEDIS?
According to the NCQA HEDIS “is the gold standard in health care performance measurement, used by more than 90 percent of the nation’s health plans and many leading employers and regulators. HEDIS is a set of standardized measures that specifies how organizations collect, audit and report performance information across the most pressing clinical areas, as well as important dimensions of customer satisfaction and patient experience.”
The HEDIS measures address a variety of medical issues including:
- Asthma Medication Use
- Persistence of Beta-Blocker Treatment after a Heart Attack
- Controlling High Blood Pressure
- Comprehensive Diabetes Care
- Breast Cancer Screening
- Antidepressant Medication Management
- Childhood and Adolescent Immunization Status
- Childhood and Adult Weight/BMI Assessment
How it is Used
“Many health plans report HEDIS data to employers or use results to improve quality of care and service.” HEDIS data is used to help employees and consumers review health plans and select the best plan for their needs. The State of Health Care Quality report, which “a comprehensive look at the performance of the nation’s health care system” also includes HEDIS data. All data is rigorously audited by certified auditors using a process designed by NCQA.