Yes. The correct age stratifications are 18-44, 45-64, 65+.
HEDIS 2018
FAQ Directory: HEDIS
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10.15.2017 Unhealthy Alcohol Use Screening and Follow-Up In the updated measure specification that was released with the HEDIS 2018 Volume 2 Technical Update, the Data Elements table includes a stratification for ages 44-64. Should this age stratification be 45-64?
10.15.2017 ECDS For IP-ECDS coverage, does NCQA look for the number of members in the initial population?
IP-ECDS coverage count includes all members in the initial population who are being managed by at least one provider with the capacity to send, receive and use electronic data for quality improvement purposes.The Initial Population includes all members (covered and not covered by ECDS) who are identified as eligible for the measure reported by the data source category used to determine eligibility.
HEDIS 2018
10.15.2017 Use of Opioids at High Dosage and Use of Opioids From Multiple Providers Step 2 of the UOD and UOP eligible population states to exclude “members who had only a single opioid medication (Opioid Medications List) dispensing event.” Does a member who had multiple prescriptions (for the same or different medications) on the same date of service (with no prescriptions on other dates of service during the measurement year) meet criteria for exclusion?
Yes. The intent is to exclude members who were dispensed opioids on only one date of service during the measurement year. If the member had multiple prescriptions (for the same or different medication) on one date of service and had no opioid prescriptions on another date of service during the measurement year, the member is excluded.
HEDIS 2018
10.15.2017 ECDS Are we required to collect and report the source vendor for the data e.g., by vendor)and source system of record (e.g., EHR, HIE, case management, claims) when reporting ECDS categories?
Details about the data vendor or source EHR system are not required for ECDS reporting, but should be documented in the HEDIS Roadmap when identifying data sources for an NCQA-Certified auditor. Use of data from NCQA eCQM-Certified vendors will ensure that measure data extracted from these systems are considered standard.
ECDS data should be categorized by one of the four source record categories stated in ECDS General Guideline 2: Data Collection Methods (EHR, HIE/clinical registry, case management registry, administrative claims).
HEDIS 2018
10.15.2017 ECDS May we use depression screening performed by case managers who are employees of a health plan and are not part of an external provider group directly serving the member?
Yes. Data collected by care/case managers employed by a health plan are appropriate, and are reported in the Case Management category in the measure report.
Care/case managers are considered part of the member’s care team because they help members manage a condition and/or their use of health care services.
HEDIS 2018
10.15.2017 ECDS How are ECDS different from supplemental data?
The ECDS reporting method uses much of the same data classified as supplemental for other HEDIS measures, but ECDS measures adhere to different reporting rules from those in other HEDIS domains. Unlike supplemental data used for HEDIS, data for ECDS reporting are classified by source and are used to report all measure elements (e.g., denominator, exclusions, numerator).
HEDIS 2018
10.15.2017 ECDS Must the eMeasure section in the Roadmap be completed for ECDS measures?
Plans work with their NCQA-Certified auditor to complete the most appropriate section of the Roadmap for the data source. The eMeasure section is intended for use by data aggregators and EHR vendors, but may be adapted and modified. Plans should work with auditors or contact NCQA with specific questions about the eMeasure Roadmap or Audit Roadmap Section 5.
HEDIS 2018
10.15.2017 ECDS What auditing process and documentation are required for ECDS sources?
The audit process for HEDIS ECDS measures is evolving. Data sources fall under audit requirements for standard supplemental data. Plans complete a Roadmap for each data source so the NCQA-Certified auditor is aware of all data that are being considered for reporting. Auditors validate policies and procedures for each data source (e.g., file layout, mapping). Although primary source verification is not required, auditors may want to validate the primary source during an initial review of data, to ensure accuracy and validity.
HEDIS 2018
10.15.2017 ECDS Clarify “data must be accessible by the health care team at point of care.”
To qualify for HEDIS ECDS reporting, practitioners/practitioner groups that are accountable for clinical services provided to members must be able to access all ECDS data used by a health plan for quality measure reporting.Qualifying modes of access may be as simple as a provider’s phone request for member information, or as sophisticated as an integrated decision support system.
HEDIS 2018
10.15.2017 ECDS Who determines that data “qualify” for ECDS reporting?
Refer to the ECDS general guidelines for information. Request clarification through the NCQA Policy Clarification Support (PCS) system at https://my.ncqa.org or review the proposed systems with your NCQA-Certified auditor. Send requests for individual technical support with ECDS reporting to ecds@ncqa.org.
HEDIS 2018
10.15.2017 ECDS If case management data are used only by behavioral health-care providers (not by primary care providers), may these data be an ECDS data source?
Case management data may be used for measures using the ECDS reporting method if the information collected by case managers is available on request to all providers treating the same member in another setting.
Data are not required to be accessed to qualify for ECDS reporting, but must be available on request to providers providing care to the member.
HEDIS 2018
10.15.2017 ECDS What happens if members seek services from a provider who cannot share health care data using ECDS?
If a member’s data cannot be classified as ECDS, the member is not included in the ECDS coverage or the measure denominator.
There are several tools for tracking patient progress (for example, https://aims.uw.edu/resource-library/excel%C2%AE-patient-tracking-template). that “convert” data into a format that is considered an ECDS for reporting quality measures.
HEDIS 2018