July 7, 2005
updated July 19, 2005
NCQA Releases HEDIS® 2006; New Measures Address Overuse, Follow-Up
Two new measures address seniors’ safe use of medications; other measures address antibiotic use, ADHD, COPD
WASHINGTON—The National Committee for Quality Assurance (NCQA) recently released specifications for the 2006 edition of its Health Plan Employer Data and Information Set (HEDIS), adding six new measures to the tool that defines how health care quality is measured in key areas of clinical care and customer service. The new measures look at a range of important health issues such as the overuse of antibiotics, proper follow-up for children and seniors taking certain medications, and diagnosis of chronic obstructive pulmonary disorder (COPD). Other measures assess the use of proper medication for rheumatoid arthritis and the appropriate use and monitoring of medication in the elderly. The latter is a subject of particular interest with Medicare’s Part D prescription drug benefit set to take effect next year.
“The right follow-up—especially for patients with persistent conditions—can be as important as getting the right care in the first place,” said NCQA Executive Vice President Greg Pawlson, M.D., M.P.H. “Adjustment and readjustment over time are a critical part of the process because not all patients respond the same way.”
The new measures include:
Use of Spirometry in Diagnosis and Assessment of COPD. Chronic obstructive pulmonary disorder (COPD) is the fourth-leading cause of death in the United States. This measure asks whether initial diagnosis of COPD involves spirometry, which is widely agreed to be the most accurate means of diagnosing the disease.
ADHD Medication Follow-up. Up to 12% of children are thought to have ADHD. This measure looks at whether children who have been prescribed ADHD medication have received systematic follow-up office visits to ensure that potential adverse side effects of these medications are avoided.
Drugs to be Avoided in the Elderly and Annual Monitoring of Patients on Persistent Medications. With Medicare's prescription drug benefit set to go into effect in the near future, the safe use of prescription drugs among Medicare beneficiaries is an issue of special interest. These two patient safety measures assess the safe use of medications: Drugs to Be Avoided in the Elderly assesses whether patients 65 and older have received prescriptions for drugs such as barbiturates that have been determined to be harmful to elderly patients, while Annual Monitoring of Patients on Persistent Medications ensures that Medicare recipients taking drugs over the long term receive appropriate follow-up.
Antibiotic Use in Adults with Acute Bronchitis. Developed in conjunction with the Centers for Disease Control and others, this measure seeks to reduce overuse of antibiotics to treat acute bronchitis, for which antibiotics are ineffective. Overuse of antibiotics increases antibiotic resistance among bacterial pathogens and costs billions of dollars annually.
Disease Modifying Anti-rheumatic Drug (DMARD) Therapy in Rheumatoid Arthritis. Anti-rheumatic drugs are believed to be significantly underused in the U.S., despite their proven effectiveness at slowing or stopping the progression of rheumatoid arthritis. The new measure seeks to encourage the use of these medications among the 2.1 million Americans affected by this disease by assessing whether patients diagnosed with rheumatoid arthritis have been prescribed a DMARD.
HEDIS 2006, Volume 2: Technical Specifications is now available in print78 and electronic formats. To order, call (888) 275-7585 or visit NCQA’s Publications Web page at www.ncqa.org/publications.
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and manages the evolution of HEDIS®, the tool the nation’s health plans use to measure and report on their performance. 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 care choices.
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HEDIS® is a registered trademark of the National Committee for Quality Assurance. All rights reserved.