HEDIS® Public Comment Period Is Now Open

February 13, 2026 · NCQA Communications

NCQA’s public comment period is open and ready for your input.

NCQA seeks public feedback on proposed new HEDIS® measures and changes to existing ones. Reviewers are asked to submit comments to NCQA in writing via the Public Comment website by 5:00 p.m. (ET), Friday, March 13. NCQA acknowledges that the healthcare policy environment is rapidly evolving, and we will consider all comments received, as well as any policy changes, as we prepare the final versions of these measures.

NCQA seeks comments on the following:

  • Seven new HEDIS measures.
  • Revisions to three existing HEDIS measures.

About HEDIS and Public Comment

HEDIS measures are based on scientific evidence. When new evidence emerges, NCQA reviews the measures to determine if changes may be needed. NCQA convenes multi-stakeholder advisory panels—including independent scientists, clinicians, health plans, purchasers, government and consumer groups—to ensure that measures meet and balance the high standards of relevance, scientific soundness and feasibility.

An important part of developing and updating HEDIS is gathering input from the public. NCQA reviews all comments received during the public comment period, and discusses results with stakeholder advisors.

HEDIS measures do not constitute clinical practice guidelines and should not be used to determine insurance or coverage.

Proposed New HEDIS Measures

Follow-Up After Positive Colorectal Cancer Non-Invasive Screening Test: Assesses the percentage of persons 45-85 years of age who received a colonoscopy for a positive colorectal cancer non-invasive screening test.

Importance: Colorectal cancer represents approximately 8% of all new cancer cases and is the third most commonly diagnosed cancer in the United States.1 Screening and early detection have a significant role in reducing the impact of this preventable and treatable disease.

Continuous Glucose Monitoring (CGM) Utilization for Patients With Diabetes: Assesses the percentage of persons 18-75 years of age with diabetes who had evidence of CGM utilization during the measurement period.

Importance: Continuous glucose monitoring supports diabetes management and helps prevent hypoglycemic and hyperglycemic events and other life-threatening complications.2 Continuous Glucose Monitoring Utilization for Patients With Diabetes is a utilization measure that provides visibility into CGM use patterns.

Intimate Partner Violence (IPV) Screening and Follow-Up: Assesses the percentage of persons 12-64 years of age who were screened for intimate partner violence using a standardized instrument, and who received follow-up care within 7 days of a positive intimate partner violence screening.

Importance: Intimate partner violence is a prevalent public health issue that harms individuals across every demographic group, with approximately 1 in 4 women and 1 in 7 men experiencing IPV in their lifetime in the U.S.3 Screening and follow-up for IPV provide a standardized manner for healthcare teams to collect information about potential safety concerns and identify when additional assessment, support or referrals may be needed.

Person-Centered Outcome Measures (3 Measures):

  • Person-Centered Outcome–Goal Identification: Assesses the percentage of persons 18 years of age and older with a complex care need who set a person-centered outcome goal.
  • Person-Centered Outcome–Goal Follow-Up: Assesses the percentage of persons 18 years of age and older with a complex care need who set a person-centered outcome goal and followed up on the goal.
  • Person-Centered Outcome–Goal Achievement: The percentage of persons 18 years of age and older with a complex care need who set a person-centered outcome goal and achieved the goal.

Importance: There is broad agreement that an individual’s goals and priorities should guide care and the quality measures used to evaluate care.4-6 For older adults with multiple chronic conditions and functional limitations, clinical guidelines have indicated the importance of providing goal-based care.7,8 For this complex population, goal setting has been shown to reduce patient-reported treatment burden and unwanted care, and it correlates with greater physical and social well-being and higher care satisfaction.9,10

Prenatal Syphilis Screening and Follow-Up: Assesses the percentage of deliveries that had a syphilis screening with a documented result during the first trimester, within 14 days of the first pregnancy diagnosis or prenatal visit, or within 30 days of enrollment in the organization, and the percentage of deliveries with a positive syphilis screen that received appropriate follow-up care.

Importance: The prevalence of congenital syphilis is increasing exponentially in the U.S., with a maternal-infant transmission rate of almost 90%. In 2024, 3,941 infants were born with congenital syphilis–a nearly 700% increase from 2015, when only 495 cases were reported.11 Syphilis screening and timely follow-up during pregnancy have a significant role in reducing the impact of transmission and adverse health outcomes for both the pregnant person and baby.

Proposed Changes to Existing HEDIS Measures

Adult Immunization Status: Assesses the percentage of adults 19 and older who are up-to-date on recommended routine vaccines. The measure includes separate rates for influenza; tetanus and diphtheria (Td) or tetanus, diphtheria, and acellular pertussis (Tdap); zoster; pneumococcal; hepatitis B; and coronavirus disease (COVID-19).

NCQA proposes two updates to the pneumococcal indicator:

  • Expanding the denominator age range from 65 and older to 50 and older.
  • Adding an age stratification for 50-64 in addition to the existing 65 and older stratification.

Emergency Department Utilization: Assesses the risk-adjusted ratio of observed to expected emergency department visits during the measurement period. NCQA proposes to expand this measure into the Medicaid product line for persons 18-64 years of age.

Pharmacotherapy Management of COPD Exacerbation: Assesses whether appropriate medications were dispensed following a chronic obstructive pulmonary disease (COPD) exacerbation for people 40 years of age and older within Medicare, Medicaid and Commercial product lines. The measure includes two separate rates: one that assesses whether a systemic corticosteroid is dispensed within 14 days of a COPD exacerbation event, and one that assesses whether a bronchodilator is dispensed within 30 days of a COPD exacerbation event.

NCQA proposes the following modifications to the measure:

  • Adding an exclusion for individuals with asthma.
  • Updating the denominator to count people instead of events and including additional qualifying COPD exacerbation events.
  • Updating the numerator to include only one rate and revising medication lists.

How to Participate in Public Comment

The public comment period ends at 5:00 p.m. (ET) on Friday, March 13. Visit My NCQA to submit comments. We’ve made some improvements to our site to make it easier for you to submit your comments.

For details on proposed changes, visit the NCQA website.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

References

­1American Cancer Society. (2023). Colorectal Cancer Facts & Figures 2023-2025. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/colorectal-cancer-facts-and-figures/colorectal-cancer-facts-and-figures-2023.pdf.

2American Diabetes Association. (2026). Continuous Glucose Monitors. https://diabetes.org/advocacy/cgm-continuous-glucose-monitors.

3Stylianou, M.A. (2018). Economic Abuse Within Intimate Partner Violence: A Review of the Literature. Violence and Victims, 33(1), 3. https://connect.springerpub.com/content/sgrvv/33/1/3.full.pdf.

4McGlynn, E. A., Schneider, E. C., & Kerr, E. A. (2014). Reimagining Quality Measurement. New England Journal of Medicine, 371(23), 2150–2153. https://doi.org/10.1056/NEJMp1407883.

5Reuben, D. B., & Tinetti, M. E. (2012). Goal-oriented patient care—An alternative health outcomes paradigm. The New England Journal of Medicine, 366(9), 777–779. https://doi.org/10.1056/NEJMp1113631.

6Tinetti, M. E., Naik, A. D., & Dodson, J. A. (2016). Moving From Disease-Centered to Patient Goals–Directed Care for Patients With Multiple Chronic Conditions: Patient Value-Based Care. JAMA Cardiology, 1(1), 9. https://doi.org/10.1001/jamacardio.2015.0248.

7American Geriatrics Society Expert Panel on the Care of Older Adults With Multimorbidity. (2012). Patient-centered care for older adults with multiple chronic conditions: A stepwise approach from the American Geriatrics Society: American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity. Journal of the American Geriatrics Society, 60(10), 1957–1968. https://doi.org/10.1111/j.1532-5415.2012.04187.x.

8The American Geriatrics Society Expert Panel on Person-Centered Care. (2016). Person-centered care: A definition and essential elements. Journal of the American Geriatrics Society, 64(1), 15–18. https://doi.org/10.1111/jgs.13866.

9Tinetti, M. E., Naik, A. D., Dindo, L., Costello, D. M., Esterson, J., Geda, M., Rosen, J., Hernandez-Bigos, K., Smith, C. D., Ouellet, G. M., Kang, G., Lee, Y., & Blaum, C. (2019). Association of Patient Priorities–Aligned Decision-Making With Patient Outcomes and Ambulatory Health Care Burden Among Older Adults With Multiple Chronic Conditions: A Nonrandomized Clinical Trial. JAMA Internal Medicine, 179(12), 1688–1697. https://doi.org/10.1001/jamainternmed.2019.4235.

10Kuipers, S. J., Cramm, J. M., & Nieboer, A. P. (2019). The importance of patient-centered care and co-creation of care for satisfaction with care and physical and social well-being of patients with multi-morbidity in the primary care setting. BMC Health Services Research, 19(1), 13. https://doi.org/10.1186/s12913-018-3818-y.

11Centers for Disease Control and Prevention. (2025). Sexually transmitted infections surveillance, 2024 (provisional).

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