Data, Measurement and Equity
To improve equity, first measure it.
Stratifying HEDIS Measures By Race & Ethnicity
Stratifying HEDIS measures is part of NCQA’s commitment to include health equity in all offerings. New for measurement year 2024, a total of 22 HEDIS measures can be stratified by race and ethnicity.
Why stratify?
Because better transparency into health plan performance by race and ethnicity will help quality advocates and health equity champions understand:
- Where disparities exist, so we can address care gaps.
- Where disparities don’t exist, so the industry can learn from top performers.
To learn more about how health plans can improve collection and management of race and ethnicity data, view the on-demand webinar or explore the Race and Ethnicity Stratification Learning Network.
How does stratification work within HEDIS measures?
- Align race and ethnicity reporting with Office of Management and Budget categories.
- Include options for “declined” if a member chooses not to provide race or ethnicity.
- Stratify separately by race and ethnicity.
- Align race and ethnicity reporting with Office of Management and Budget categories.
To learn more about HEDIS stratification, visit The Future of HEDIS.
Download the Resource Guide for Auditors.
What measures can be stratified by race and ethnicity?
For more information on measures in which stratified rates will be publicly reported as aggregate benchmarks (not plan-level results) for MY 2023, visit the HEDIS MY 2023 Public Reporting Memo.
BY DOMAIN
Currently required in NCQA’s Health Equity Accreditation. Stratified rates will be publicly reported as aggregate benchmarks for MY 2023.
Access and Availability of Care
| Measure | Stratification Added | ECDS Only |
| Prenatal and Postpartum Care (PPC) | MY 2022 | n/a |
| Initiation and Engagement of Substance Use Disorder Treatment (IET) | MY 2023 |
Behavioral Health
| Measure | Stratification Added | ECDS Only |
| Follow-Up After Emergency Department Visit for Substance Use (FUA) | MY 2023 | n/a |
| Pharmacotherapy for Opioid Use Disorder (POD) | MY 2023 | |
| Follow-Up After Hospitalization for Mental Illness (FUH) | MY 2024 | |
| Follow-Up After Emergency Department Visit for Mental Illness (FUM) | MY 2024 |
Cardiovascular
| Measure | Stratification Added | ECDS Only |
| Controlling High Blood Pressure (CBP) | MY 2022 | n/a |
Diabetes
| Measure | Stratification Added | ECDS Only |
| Glycemic Status Assessment for Patients With Diabetes (GSD) | MY 2022 | n/a |
| Eye Exam for Patients With Diabetes (EED) | MY 2024 | n/a |
| Kidney Health Evaluation for Patients With Diabetes (KED) | MY 2024 | n/a |
Measures Reported Using ECDS
| Measure | Stratification Added | ECDS Only |
| Adult Immunization Status (AIS-E) | MY 2023 | MY 2018 |
| Immunization for Adolescents (IMA, IMA-E) | MY 2023 | MY 2025 |
| Breast Cancer Screening (BCS-E) | MY 2023 | MY 2023 |
| Colorectal Cancer Screening (COL-E) Note: Although both COL and COL-E are stratified in MY 22 and MY 23, NCQA will only release the aggregate benchmarks for COL (not for COL-E) for MY 23. | MY 2022 | MY 2024 |
| Childhood Immunization Status (CIS-E) Note: Stratification is only specified for Combo 10—all vaccines. | MY 2024 | MY 2025 |
| Cervical Cancer Screening (CCS-E) | MY 2024 | MY 2025 |
| Prenatal Immunization Status (PRS-E) | MY 2024 | MY 2018 |
| Prenatal Depression Screening and Follow-Up (PND-E) | MY 2024 | MY 2019 |
| Postpartum Depression Screening and Follow-Up (PDS-E) | MY 2024 | MY 2019 |
Prevention & Screening/ Measures Reported Using ECDS
| Measure | Stratification Added | ECDS Only |
| Immunization for Adolescents (IMA, IMA-E) | MY 2023 | MY 2025 |
Utilization
| Measure | Stratification Added | ECDS Only |
| Well-Child Visits in the First 30 Months of Life (W30) | MY 2023 | n/a |
| Child and Adolescent Well Care Visits (WCV) | MY 2022 |
HEDIS AND HEALTH EQUITY
To learn more about how HEDIS measures help to advance health equity, download NCQA published reports and reviews of key topics.
Cervical and Breast Cancer Screening: Evidence and Guidelines to Support Inclusive Quality Measures
Topics include:
- Navigating guidelines for the care of gender-diverse patients.
- Newer data standards for collecting sex and gender data.
Health Equity and Social Determinants of Health in HEDIS: Data for Measurement
Read more about key considerations in HEDIS for assessing and advancing health equity, including:
- Definitions of frequently used terms—including terms that are often conflated or misused.
- Using HEDIS to gauge language diversity and racial/ethnic diversity among health plan members.
- Using administrative and community-level proxy data to detect social needs.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).