NCQA Releases 2015 HEDIS Measures for Public Comment; Proposes Eight New Measures Addressing Use of Antipsychotics and Cancer Screenings

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On Feb. 19, the National Committee for Quality Assurance (NCQA) released its 2015 Healthcare Effectiveness Data and Information Set (HEDIS) for public comment, proposing eight new measures, proposing changes to seven existing measures, and retiring two measures.

The eight new proposed measures focus on cancer screening and use of antipsychotics in the pediatric population:

    Non-recommended PSA-based screening in older men.
    Non-recommended colorectal cancer screening in older adults.
    Use of higher than recommended doses of antipsychotics in children and adolescents.
    Use of multiple concurrent antipsychotics in children and adolescents.
    Use of first-line psychosocial care for children and adolescents on antipsychotics.
    Follow-up visit for children and adolescents on antipsychotics.
    Metabolic screening for children and adolescents newly on antipsychotics.
    Metabolic monitoring for children and adolescents on antipsychotics.

Some proposed changes include:

    For measures addressing osteoporosis testing and management: NCQA proposes to set an upper age limit of 85 years, given the limited benefit in testing patients over 85.
    Remove the LDL control measure from the Comprehensive Diabetes Care measure due to the recent release of ACC/AHA guidelines that do not specify LDL targets for treatment.
    Revise the all-cause plan readmissions measure to improve measure validity and align with the CMS Hospital Wide Readmissions measure.
    Change the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Health Plan and Patient-Centered Medical Home PCMH surveys based on AHRQ recommendations.

    Finally, NCQA proposes to retire two measures: 1) glaucoma screening in older adults, and 2) cholesterol management for patients with cardiovascular conditions.

More than 90 percent of health plans use HEDIS to measure performance on important dimensions of care. CMS uses several HEDIS measures in both public reporting and pay-for-performance programs, as well as by state, regional, and national programs.

Mental health is an area that various healthcare stakeholders, including the Measures Application Partnership (MAP), recognize as a significant gap area. Before 2012, HEDIS focused minimally on antipsychotic-use, but has since prioritized mental health. Additionally, the proposed colorectal cancer and PSA-based screening measures, which are supported by USPSTF, could lead to decreased use of those screening tests moving forward.

NCQA will review all comments and make recommendations to NCQA’s Committee on Performance Measurement based on public feedback. A final measure is set for release in July 2014.

For more information on the proposed measures, updated measures, and retired measures, click here.

Comments can be submitted online until March 20.

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