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Data, Measurement and Equity

To improve equity, first measure it.

Download the Resource Guide for Auditors

Learn more about HEDIS stratification and measurement in this resource guide for auditors.

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STRATIFYING HEDIS MEASURES BY RACE & ETHNICITY

NCQA is expanding the race and ethnicity stratification to 8 HEDIS measures in measurement year 2023, bringing the total number of stratified measures to 13.

Why stratify? Because better transparency into health plan performance by race and ethnicity will help quality advocates 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 the HEDIS stratification, see our February 2021, June 2021 and October 2022 webinars, The Future of HEDIS: Health Equity (in Webinar Archives, Episodes 8, 9 and 12).

Here is a quick summary of how the stratification works in HEDIS:

  • 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.
  • Allow reporting of self-reported member data and indirect imputed data–regardless of completeness and using separate reporting fields.
  • Use existing HEDIS audit and hybrid sampling guidelines.

Stratifying HEDIS measures is part of our agenda to Investigate inequities in care.

Our interest in stratifying measures stems from our belief that improving equity starts with data.

HEDIS AND HEALTH EQUITY

A June 2021 Issue Brief from NCQA summarizes key considerations in using HEDIS to assess and advance health equity.

Topics include:

  • Defining 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.

Download Health Equity and Social Determinants of Health in HEDIS: Data for Measurement.