Proposed Updates for Health Plan Ratings (HPR) 2023 (HEDIS MY 2022)
For HPR 2023, NCQA proposes to revise four existing measures/indicators and four new measures/indicators.
Measures/indicators for revision include:
- Replace Comprehensive Diabetes Care (CDC)—BP Control <140/90 with Blood Pressure Control for Patients with Diabetes (BPD).
- Replace Comprehensive Diabetes Care (CDC)—Eye Exams with Eye Exam for Patients with Diabetes (EED).
- Replace Comprehensive Diabetes Care (CDC)—HbA1c Control <8% with Hemoglobin A1c Control for Patients with Diabetes (HBD)—HbA1c Control <8%.
- Replace Use of High-Risk Medications in Older Adults (DAE)—Rate 1 with Use of High-Risk Medications in Older Adults (DAE)—Rate 3.
New measures/indicators include:
- Kidney Health Evaluation for Patients With Diabetes (KED) for all three product lines.
- Osteoporosis Screening in Older Women (OSW) for the Medicare product line.
- Appropriate Testing for Pharyngitis (CWP) for the Medicare product line.
- Appropriate Treatment for Upper Respiratory Infection (URI) for the Medicare product line.
- Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB) for the Medicare product line.
- Race/Ethnicity Diversity of Membership (RDM) for all three product lines.
The proposed changes below may be modified or eliminated based on public comment and other feedback.
The Health Plan Ratings 2023: Overview of Proposed Measure Updates provides background for proposed changes and topic-specific questions.
Appendix 1: Proposed HEDIS/CAHPS Updates for 2023 Health Plan Ratings includes the measures proposed for inclusion and retirement, and the rationale.
About Public Comment
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- Interactive Data Submission System (IDSS).
- Health Organization Questionnaire (HOQ).
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Submit all comments through the My NCQA portal. NCQA does not accept comments by mail, email or fax.
- Go to http://my.ncqa.org and enter your email address and password.
- Once logged in, scroll down and click Public Comments.
- Click Add Comment to open the comment box.
- Select Health Plan Ratings (Health Plan Ratings) 2023 from the drop-down box.
- Click to select the Topic and Element (question) on which you would like to comment.
- Click to select your support option (Support, Do not support, Support with modifications).
- If you choose Do not support, include your rationale in the text box.
- If you choose Support with modifications, enter the suggested modification in the text box.
- Enter your comments in the Comments
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- Use the Submit button to submit more than one comment. Use the Close button to finish leaving comments; you can view all submitted comments in the Public Comments
All comments must be entered by January 10, 2022, at 11:59 p.m. ET