The Mihalik Blog

HEDIS® Public Comment Open

Last week, NCQA opened the public comment periodon proposed changes to HEDIS 2010. 

 

A new CAHPS measure, Aspirin Use and Discussion, is proposed.  The measure will include rates for Current Aspirin Use and Discussing Aspiring Risks and Benefits (with a doctor or provider).

 

Changes are proposed to the following measures:

·         Years in Business/Total Membership

·         Medical Assistance with Smoking Cessation

·         Colorectal Cancer Screening

·         Appropriate Treatment for Children with Upper Respiratory Infection

·         Use of Appropriate Medications for People with Asthma

 

There also are proposed changes to Technical Specifications and Specifications for Survey Measures.

 

The public comment period lasts until March 17, 2009. 

 

  

 

 

Behavioral Health HEDIS Change Proposed

For those of you who have struggled with the Behavioral Health HEDIS measures—and who hasn’t—there appears to be some good news. 

 

NCQA is proposing to eliminate the measure on Optimal Practitioner Contact for members in treatment for depression in the 2009 reporting year.

 

The measures for Acute and Continuation Phase Treatment with antidepressant medications will likely remain. 

Optimal Practitioner Contacts has been a particularly difficult measure to move.  Across health plans, Acute and Continuation Phase Treatment has inched up over the years—at least for Commercial and Medicare product lines. 

 

You can find the complete list of 2008 HEDIS measures here.

Performance Measurement

I’ve been doing quite a number of speaking engagements over the past few months.  Many of them have been on HEDIS.  Most of these are for health plan audiences or for practitioners who are in health plan networks.  One upcoming HEDIS is for hospital staff.  One I did recently for the St. Louis Professionals for Health Care Quality included quality professionals from health plans and hospitals. 

I’ve been questioned about why hospital staff would want to learn about HEDIS.  While it’s true the HEDIS doesn’t have the impact on hospitals that it has on health plans (for which HEDIS results are a major component of NCQA’s health plan accreditation process), HEDIS is a good model.

First off, HEDIS works.  Its standardized measurement process is implemented across the country, allowing reliable comparisons to be made on outcomes between health plans.  Doing something similar for hospitals was the Joint Commission’s dream for the Indicator Measurement System back in the early 1990s.  Unfortunately they failed to even come close to the goal, in the process missing a historic opportunity to implement a modernized version of Ernest Codman’s End Results System.  I believe it also stalled the process of furthering the quality agenda for hospitals.  But I digress…

Increasingly, HEDIS serves as the basis for health plans constructing practitioner-level performance measures.  While these are not (yet) reportable to NCQA, their frequency has prompted NCQA to issues specifications for practitioner-level HEDIS as a way of improving reliability.

Even though practitioner-level HEDIS is not reportable to NCQA, NCQA is putting a major investment of resources into developing practitioner level performance measures.  The latest effort to be unveiled is a set of measures for HIV/AIDS.  These measures, which can be implemented at the practitioner or system level, look more like HEDIS measures than the ones in NCQA’s Practitioner Recognition Programs—perhaps signaling a new trend. 

Whether a health care organization needs to implement HEDIS measures or not, it is clear that one can learn quite a bit from NCQA’s success in implementing national outcome measurement processes for diverse audiences. 

Since our inception, The Mihalik Group has assisted health care organizations develop and implement performance measurement initiatives and improve performance.