HEDIS and ICD-10
To comply with CMS requirements, health care providers will be required to switch to ICD-10 Diagnosis and Procedure codes effective October 1, 2014. To accommodate the change, NCQA will identify ICD-10 codes in time for their inclusion in HEDIS 2015 publications. NCQA developed the following process to identify a valid and appropriate set of ICD-10 codes for each HEDIS measure.
HEDIS and Relative Resource Use (RRU)
When linked with HEDIS quality data, RRU measures help members, plans, employers, benefit managers and other interested groups, make informed choices about health care services. Members get a more detailed look at the value of services they pay for, while plans can see how effectively they use resources, compared to other plans, when delivering health care.