HEDIS 2018 Measures

The Healthcare Effectiveness Data and Information Set (HEDIS®) is one of the most popular ways to measure and improve health care. It tracks the quality of care that 184 million people, or 57 percent of the US population, receive. The excerpt below includes measures from five domains of care.

Effectiveness of Care

Prevention and Screening

Adult BMI Assessment
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Childhood Immunization Status
Immunizations for Adolescents
Lead Screening in Children
Breast Cancer Screening
Cervical Cancer Screening
Colorectal Cancer Screening
Chlamydia Screening in Women
Care for Older Adults

Respiratory Conditions

Appropriate Testing for Children With Pharyngitis
Use of Spirometry Testing in the Assessment and Diagnosis of COPD
Pharmacotherapy Management of COPD Exacerbation
Medication Management for People With Asthma
Asthma Medication Ratio

Cardiovascular Conditions

Controlling High Blood Pressure
Persistence of Beta-Blocker Treatment After a Heart Attack
Statin Therapy for Patients With Cardiovascular Disease

Diabetes

Comprehensive Diabetes Care
Statin Therapy for Patients With Diabetes

Musculoskeletal Conditions

Disease-Modifying Anti-Rheumatic Drug Therapy for Rheumatoid Arthritis
Osteoporosis Management in Women Who Had a Fracture

Behavioral Health

Antidepressant Medication Management
Follow-Up Care for Children Prescribed ADHD Medication
Follow-Up After Hospitalization for Mental Illness
Follow-Up After Emergency Department Visit for Mental Illness
Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence
Diabetes Screening for People With Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications
Diabetes Monitoring for People With Diabetes and Schizophrenia
Cardiovascular Monitoring for People With Cardiovascular Disease and Schizophrenia
Adherence to Antipsychotic Medications for Individuals With Schizophrenia
Metabolic Monitoring for Children and Adolescents on Antipsychotics

Medication Management and Care Coordination

Annual Monitoring for Patients on Persistent Medications
Medication Reconciliation Post-Discharge
Transitions of Care
Follow-Up After Emergency Department Visit for People With High-Risk Multiple Chronic Conditions

Overuse/Appropriateness

Non-Recommended Cervical Cancer Screening in Adolescent Females
Non-Recommended PSA-Based Screening in Older Men
Appropriate Treatment for Children With Upper Respiratory Infection
Avoidance of Antibiotic Treatment in Adults With Acute Bronchitis
Use of Imaging Studies for Low Back Pain
Use of Multiple Concurrent Antipsychotics in Children and Adolescents
Potentially Harmful Drug-Disease Interactions in the Elderly
Use of High-Risk Medications in the Elderly
Use of Opioids at High Dosage
Use of Opioids from Multiple Providers

Measures Collected Through the Medicare Health Outcomes Survey

Medicare Health Outcomes Survey
Fall Risk Management
Management of Urinary Incontinence in Older Adults
Osteoporosis Testing in Older Women
Physical Activity in Older Adults

Measures Collected Through the CAHPS® Health Plan Survey

Flu Vaccinations for Adults Ages 18-64
Flu Vaccinations for Adults Ages 60 and Older
Medical Assistance with Smoking and Tobacco Use Cessation
Pneumococcal Vaccination Status for Older Adults

Access/Availability of Care

Adults’ Access to Preventive/Ambulatory Health Services
Children and Adolescents’ Access to Primary Care Practitioners
Annual Dental Visit

Experience of Care

CAHPS Health Plan Survey 5.0H, Adult Version
CAHPS Health Plan Survey 5.0H, Child Version
Children With Chronic Conditions

Utilization and Risk Adjusted Utilization

Utilization

Frequency of Ongoing Prenatal Care
Well-Child Visits in the First 15 Months of Life
Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life
Adolescent Well-Care Visits
Frequency of Selected Procedures
Ambulatory Care
Inpatient Utilization—General Hospital/Acute Care
Identification of Alcohol and Other Drug Services
Mental Health Utilization
Antibiotic Utilization
Standardized Healthcare-Associated Infection Ratio

Risk Adjusted Utilization

Plan All-Cause Readmissions
Inpatient Hospital Utilization
Emergency Department Utilization
Hospitalization for Potentially Preventable Complications

Measures Collected Using Electronic Clinical Data Systems

Depression Screening and Follow-Up for Adolescents and Adults
Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults
Depression Remission or Response for Adolescents and Adults
Unhealthy Alcohol Use Screening and Follow-Up
Pneumococcal Vaccination Coverage for Older Adults

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

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