HEDIS^® Public Comment

WHAT IS PUBLIC COMMENT?

Public comment offers an opportunity for participants from across the healthcare ecosystem to share feedback directly with NCQA about proposed updates to our programs. Public comment is an important part of maintaining the HEDIS measure set. NCQA reviews all comments received during the public comment process and presents results to advisory panels and to the NCQA Committee on Performance Measurement for deliberation. NCQA will communicate final determinations through established channels following completion of its review and approval process.

AD HOC MY 2027 PUBLIC COMMENT OVERVIEW

NCQA is evolving HEDIS to better reflect where quality measurement is headed: toward a more focused, meaningful portfolio that delivers clearer, more actionable signals and supports improvement in care, accountability and value across the healthcare system. Measure retirement is an important part of this ongoing curation work, helping ensure the portfolio adapts to advances in evidence, clinical practice, data availability, policy priorities and stakeholder needs.

For Measurement Year 2027, NCQA is proposing to retire ten HEDIS measures through its structured measure curation process. This proposal is intended to strengthen the HEDIS portfolio by identifying measures that may no longer provide strong signals for quality improvement, benchmarking, or accountability relative to the burden of continued reporting and maintenance.

NCQA recognizes that the topics reflected in these measures, including behavioral health and substance use care, represent areas of critical, ongoing need for quality improvement. Our commitment to advancing them is steadfast. The proposed retirements do not signal a retreat from these priorities. Rather, they reflect a focus on better measurement strategies that align with current evidence, provide meaningful and actionable insights to stakeholders and are positioned to have greater impact on care and outcomes for patients. Retiring measures ensures that our portfolio continues to keep pace with the rate of change in healthcare and drives improvement in the areas where it matters most.

PUBLIC COMMENT MATERIALS

Measures under consideration for retirement for MY 2027:

• Documented Assessment After Mammogram (DBM-E)
• Oral Evaluation, Dental Services (OED)
• Topical Fluoride for Children (TFC)
• Diagnosed Mental Health Disorders (DMH)
• Diagnosed Substance Use Disorders (DSU)
• Diabetes Monitoring for People With Diabetes and Schizophrenia (SMD)
• Cardiovascular Monitoring for People With Cardiovascular Disease and Schizophrenia (SMC)
• Use of Opioids at High Dosage (HDO)
• Risk of Continued Opioid Use (COU)
• Language Description of Membership (LDM)

RATIONALE FOR PROPOSED RETIREMENT

NCQA’s measure curation effort is guided by a broader modernization strategy focused on advancing HEDIS measures that are meaningful, actionable, and aligned with the future of healthcare quality measurement. Key principles include prioritizing measures that are linked to improved patient outcomes, access, affordability and experience; that provide longitudinal insights into quality over time; and that deliver actionable information for health systems, clinicians, health plans, and purchasers. NCQA also considers whether measures are supported by reliable and feasible data, whether they can be harmonized across payers and programs to reduce duplication and whether they help move the portfolio toward measures that matter, leading NCQA to retire low-value and unnecessary process measures that no longer drive quality improvement.

Within this framework, NCQA evaluated existing measures to determine if updates, retirement or replacement were appropriate. Evaluation ensures HEDIS measures remain evidence-based, clinically meaningful and feasible to implement. Measures considered for retirement may have limited impact on quality improvement, low actionability, small populations, consistently high performance with little variation, overlap with other measures, significant reporting burden relative to value, or reduced alignment with evolving clinical guidelines. Together, these considerations help ensure the HEDIS measure portfolio remains meaningful, effective, and aligned with the needs of the healthcare system.

STATUS AND REPORTING IMPLICATIONS

At the time of this announcement, these measures are under consideration for retirement and final decisions are forthcoming. Organizations should continue to follow current HEDIS specifications and reporting requirements unless and until NCQA communicates a final decision.

PROVIDE YOUR FEEDBACK

NCQA invites comments from stakeholders, including health plans, clinicians, purchasers, policy makers and other interested parties. Feedback received through public comment will be carefully reviewed and considered in final decisions.

NCQA will communicate final determinations through established channels following completion of its review and approval process.

COMMENT SUBMISSION INSTRUCTIONS

About Public Comment

The public comment system is integrated with NCQA’s single sign-on platform. If you have access to any system listed below, you can use the same credentials to log in and submit comments:

• Interactive Data Submission System (IDSS).
• Health Organization Questionnaire (HOQ).
• Download Center.
• Recognition Program Online Application.
• Quality Compass®.

Note: If you use the Forgot Password feature, you will change your password for all NCQA systems to which you have access.

If you don’t have access to any system listed, click Create Account and complete the entire form. Retain the password for your records.

How to Comment

Submit all comments through NCQA’s public comment website. NCQA does not accept comments via mail, email or fax.

1. Go to https://my.ncqa.org/.
2. Once logged in, click to select Public Comments.
3. Click Add Comment.
4. Select the name of the organization you are submitting comments for.
5. In the box labeled Ad Hoc HEDIS MY 2027 Public Comment, click the Instructions link to view public comment materials, including instructions and proposed measure specifications.
6. Click Take Survey.
7. Review the survey description and instructions, then click the Begin button.
8. Answer the questions you would like to provide feedback on. You are not required to comment on every item; required questions will be marked with a red asterisk.
   1. For support type questions, select your support option (i.e., Support, Do Not Support, Support with Modifications).
      Note: If you chose Do Not Support, include the reason in the text box. If you chose Support with Modifications, enter the suggested modifications in the text box.
   2. Answer any additional questions in the section and enter relevant comments in the associated text boxes.
      Note: Text boxes allow up to 50,000 characters.
9. Click Next at the bottom of the page. Repeat step 8 for each page.
   Note: Use the Back button if you would like to change any of your responses.
10. On the final page, click Submit.

All comments are due Monday, August 17, by 11:59 p.m. (ET).

QUESTIONS?

Contact NCQA Customer Support at 888-275-7585, Monday-Friday, 8:30 a.m.-5:00 p.m. (ET).