FAQ Directory: HEDIS

Yes. The data elements for “ExclusionAdminOptional” and “ExclusionMedRecsOptional” are not reported for MY 2022. These data elements and reporting instructions should be removed from Table LSC-1: Data Elements for Lead Screening in Children.

HEDIS MY 2022

Yes. The reporting instructions for the initial population and exclusions data elements for ASF-E and DSF-E for MY 2022 and MY 2023 are incorrect. The reporting instructions should state, “For each stratification, repeat per metric” for the initial population and exclusions data elements. Refer to the PDF  for the corrected data elements tables.
Note: The information is correct in IDSS (the validations check "For each stratification, repeat per metric” for the initial population and exclusions data elements).

**This FAQ applies to both HEDIS Volume 2 MY 2022 and HEDIS Volume 2 MY 2023

HEDIS MY 2022

No. Members who die during the measurement year must be removed from all applicable measures. For episode-based measures, a member who died during the measurement year must be removed for all events (even if they meet numerator criteria for an event).

HEDIS MY 2023

The Statin Therapy for Patients With Cardiovascular Disease (SPC) and Statin Therapy for Patients With Diabetes (SPD) measures include an exclusion for members with myalgia, myositis, myopathy or rhabdomyolysis during the measurement year. However, an allergy or history of an intolerance to a statin medication is not considered an exclusion for the measure.  
The general guidance NCQA received from our experts, as well as guidance from the American College of Cardiology , is that patients with atherosclerotic cardiovascular disease should be rechallenged on lower statin doses and alternative statins before being put on non-statin therapies (e.g., PCSK-9 inhibitors) due to statin intolerance. The decision-making process might vary from case to case. Although we incorporated exclusions for muscle-related statin side effects, we acknowledge that the measure may not address all instances of true statin intolerance. We will consider all feedback on this issue, while also ensuring that changes to the measure are valid, scientifically sound and true to the measure's intent (to measure the quality of cardiovascular care provided at the population level).

HEDIS MY 2022

The Hemoglobin A1c Control for Patients With Diabetes measure should be removed from the measure list. The Plan All-Cause Readmissions measure should be added to the list. This clarification will be in the MY 2023 Technical Update.

HEDIS MY 2023

If your organization needs an invoice prior to placing your order for Quality Compass, please reach out to our Information Products team by submitting a case through your my.NCQA.org account.
 

HEDIS MY 2021

No. A correction will be in the MY 2023 Technical Update. The Ages section in the Eligible Population should read as follows:
Members who were 3 months of age or older as of the Episode Date. Report three age stratifications and a total rate:

• 3 months–17 years.
• 18–64 years.
• 65 years and older.
• Total.

The total is the sum of the age stratifications.

HEDIS MY 2023

Quality Compass is priced according to the number of users, years of trended data, and whether your organization needs access to the Data Exporter feature. The cost breakdown is available on our pricing table on the NCQA Store .
 

HEDIS MY 2021

We recommend that organizations not use PCS responses that are over 3 years old. If a question relates directly to a measure specification or a general guideline that was revised from a previous measurement year, you should resubmit the question.

HEDIS MY 2023

You can find the standard guidelines and restrictions for data usage in Section 2 of the Quality Compass license agreement. This agreement in located on our website as well as on the NCQA store site, prior to any purchase of a license. If you expect your data usage to fall outside of the permissions set forth in the standard agreement, NCQA offers customized agreements to grant extended permissions and use cases, subject to a separate fee.

If you are unsure if your use case falls outside the standard license terms, submit your question via my.ncqa.org for further assistance.
 

HEDIS MY 2021

Customers interested in accessing prior year data can choose to add up to three years of trended results to their Quality Compass purchase. For example, if you purchase Quality Compass 2022 (MY 2021), you can choose to add the trended data feature to access MY 2020 MY 2019 results.

It is important to note that not all data can be trended due to significant changes in the measure specifications. Quality Compass indicates when measures should be trended with caution or if there has been a break in trending and results should not be trended year-to-year. These trending determinations can be found on the Help tab within the Quality Compass tool or in the Volume 2 HEDIS technical specifications.

Access to the latest data year must be purchased annually.
 

HEDIS MY 2021

If you do not need access to all the data results available within Quality Compass, you can request a custom data extract. Pricing for data extracts start at $2,500 and are determined by the amount of data requested and the client’s use case.

You can obtain a custom quote by reaching out to the Information Products team and completing a data request form that details your data needs and requested permissions.
 

HEDIS MY 2021