February 21, 2007
New HEDIS® Measures Track Childhood Lead Screening, COPD Management
Retirement of Beta-Blocker Measure Marks Major Accomplishment in Cardiac Care
WASHINGTON—Under a new quality measure proposed today by the National Committee for Quality Assurance (NCQA), children under 2 years of age enrolled in Medicaid managed care plans would be tested for exposure to lead. The new addition to the Health Plan Employer Data and Information Set (HEDIS®) would help detect elevated levels of exposure to lead among the 310,000 children estimated to be at risk for pediatric lead poisoning.
High blood lead levels have substantial health implications that are often irreversible in children, and lead to unnecessary medical expenses. Studies estimate that a child with high levels of lead in his or her blood incurs, on average, $1,300 in avoidable medical costs.
“Lead poisoning can have a devastating impact on childhood development. Screening is simple and inexpensive. There’s no reason for this not to be part of routine well-child care for those at risk,” said, Greg Pawlson, M.D., M.P.H., NCQA’s executive vice president.
A second new HEDIS measure being released for public comment seeks to improve the management of chronic obstructive pulmonary disease (COPD), a condition affecting more than 10 million Americans. The new measure examines whether patients with aggravated COPD receive prescriptions for bronchodilators and systemic corticosteroids upon discharge from a hospital or emergency department. Such medications have been shown to shorten recovery periods, prevent relapses, and reduce the number of COPD who die prematurely.
NCQA is also proposing to retire several existing HEDIS measures—notable among them a measure that assesses whether beta-blockers are prescribed after a heart attack. Since 1996, NCQA has required health plans to collect and report on beta-blocker use. During that time, the use of these life-saving drug therapies has increased from an average of 63 percent to nearly 97 percent in 2005, a change that has saved more than 5,300 lives. In 2005, NCQA introduced a new, more stringent beta-blocker measure that assesses whether patients stay with beta-blocker treatment six months after a heart attack.
“If you have a heart attack today, it’s nearly a given that you’ll be prescribed a beta-blocker. That wasn’t the case 10 years ago,” said NCQA’s Pawlson. “The widespread use of simple, inexpensive medications has prevented numerous second heart attacks—and the complex, expensive interventions that come with them. It’s a real quality improvement success story.”
With the release of the 2008 draft, NCQA also requests comments on its proposal to change a number of existing HEDIS measures, including changes to the Childhood Immunization Status measures and several access measures that determine the extent to which children and adolescents see their primary care physician for a checkup.
The relevant sections of the HEDIS 2008 draft can be downloaded from NCQA’s Web site, www.ncqa.org. Members of the public are invited to provide input on the measures through March 20; details on how to submit public comment are available on the Web site. The public comment will inform the final version of the measures to be presented to NCQA’s Committee on Performance Measurement and Board of Directors, a wide range of health care thought leaders including physicians, purchasers, consumers, labor and plan representatives.
Final standards will be released later this summer. As with all first-year HEDIS measures, data for the new measures will be collected, reported and audited in 2008; however, the results of the first year of measurement will not be publicly reported.
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA is the nation’s leading developer of health care evaluation tools including health plan accreditation, physician recognition and organization certification. NCQA also is responsible for the evolution of HEDIS®, the most widely used set of health care performance measures. NCQA is committed to providing health care quality information through the Web, media and data licensing agreements in order to help consumers, employers and others make more informed health choices.
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