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NCQA Seeks Public’s Help on HEDIS® Measures for Health Plan Accreditation in 2019

Health Plan Accreditation Public Comment is open November 14–December 15 for HEDIS Measures scored in 2019

WASHINGTON, DC—The National Committee for Quality Assurance (NCQA) invites the public to comment on Healthcare Effectiveness Data and Information Set (HEDIS®) measures included in Health Plan Accreditation (HPA) scoring for the 2019 reporting year. This is an opportunity for health plans, purchasers, consumers and other stakeholders to weigh in on the relevance and feasibility of measures proposed for scoring in HPA. The changes pursue better alignment between the Health Plan Ratings (HPR) measure set and the HPA measure set.

NCQA proposes to add these measures to those scored in HPA

  • For commercial plans:
    • Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM).
    • Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP). 
    • Prenatal and Postpartum Care (PPC)—Timeliness of Prenatal Care Rate.

NCQA proposes to remove these measures from scoring in HPA

  • For commercial and Medicare plans:
    • Persistence of Beta-Blocker Treatment After a Heart Attack (PBH).

For measures with multiple indicators, NCQA proposes to remove these indicators from scoring in HPA to focus on the more desirable rate

  • For commercial, Medicare and Medicaid plans:
    • Antidepressant Medication Management (AMM)—Acute Phase Rate.
    • Initiation and Engagement of Alcohol and Other Drug Dependence Treatment (IET)—Initiation Rate.
    • Statin Therapy for Patients with Cardiovascular Disease (SPC)—Received Statin Therapy Rate.
    • Statin Therapy for Patients with Diabetes (SPD)—Received Statin Therapy Rate.
  • For commercial and Medicaid plans:
    • Follow-Up for Children Prescribed ADHD Medication (ADD)—Initiation Phase Rate.
    • Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC)—Counseling for Physical Activity and Counseling for Nutrition Rates

The public comment site is

Public Comment Period: November 14–Dec 15, 2017.

Media Contacts

Matt Brock

Cindy Peña