Beginning with HEDIS 2021, HEDIS measure data will be collected in the new format through the updated IDSS system. With this new format, the data elements under the measures will be more relational, modular, reusable and meaningfully named and structured. Measures with different stratifications will have data points gathered in groups such as age, gender and socio-economic status.
The submission file redesign has four goals:
- Make measure data elements more relational, modular and meaningfully named (eliminate unique variable names) to align with Volume 2 descriptions.
- Create a stronger schema with validations to collect allowed data elements under various stratifications.
- Standardize the measure structure that clearly segregates metadata and stratification data and
allows the inclusion of rates, if needed, specifically at the total and subtotal levels. - Collect only plan reported data elements (i.e., do not collect IDSS calculated data elements).
The proposed structure will have a MeasureCode with Metadata, Metric/Rate Name sections, with a stratification subsection for respective stratifications, if applicable, and a data subsection to collect plan-provided values. Results and other NCQA calculated values will be provided in the redesigned results file.
Submission Files
- Commercial (updated 4/30/2019)
- Marketplace (updated 4/30/2019)
- Medicaid (updated 4/30/2019)
- Medicare (updated 4/30/2019)
Mapping Files
- Commercial (updated 4/30/2019)
- Marketplace (updated 4/30/2019)
- Medicaid (updated 4/30/2019)
- Medicare (updated 4/30/2019)
Results Files
- Commercial – .xml version (updated 7/29/2019)
- Marketplace – .xml version (updated 7/29/2019)
- Medicaid – .xml version (updated 7/29/2019)
- Medicare – .xml version (updated 7/29/2019)
- Medicare – All Measure Types – .csv version (updated 7/29/2019)
- Medicare – Health Plans – .csv version (updated 7/29/2019)
- Medicare – Quality – .csv version (updated 7/29/2019)
- Medicare – Use – .csv version (updated 7/29/2019)
Data Dictionary
- Results – Commercial (updated 7/29/2019)
- Results – Marketplace (updated 7/29/2019)
- Results – Medicaid (updated 7/29/2019)
- Results – Medicare (updated 7/29/2019)
Communication
- IDSS Redesigned Results File Announcement (updated 7/29/2019)
- HEDIS 2019 Measure Submission Layout Announcement (updated 4/30/2019)
Supporting Documents
- HEDIS 2019 Submission File Redesign Template (updated 4/30/2019)
- HEDIS 2019 Results File Redesign Template (updated 7/29/2019)