- The National Committee for Quality Assurance (NCQA) is seeking comments from health plans, purchasers, consumers, and other stakeholders on proposed updates to the Healthcare Effectiveness Data and Information Set (HEDIS) measures.
“When clinical guidelines change, or new evidence becomes available in the scientific literature, NCQA reviews HEDIS measures to determine whether changes may be needed. NCQA convenes multi-stakeholder advisory groups to ensure that measures meet and balance the high standards of relevance, scientific soundness and feasibility,” the organization said.
“Public review and comment is an important part of developing, updating and retiring HEDIS measures. NCQA reviews all comments received during public comment and presents results to multi-stakeholder advisory groups and the NCQA Committee on Performance Measurement for deliberation.”
NCQA is proposing to retire measures having to do with the utilization of ambulatory care, as well as general hospital and acute care, including maternity and surgery services. The committee is also proposing to retire osteoporosis testing in women between the ages of 65 and 85 who report ever having received a bone mineral density test on their hip or back.
Additionally, NCQA is moving to retire a measure about assessing children and adolescents who are prescribed multiple antipsychotics concurrently, as the prevalence of this is extremely low.
Newly proposed measures include follow-up for patients who have received high-intensity care for substance use disorders (SUDs).
“SUDs are a significant contributor to morbidity and mortality. Although clinical guidelines recommend follow-up care after ‘high-intensity’ treatment, few individuals receive any treatment or follow-up care,” NCQA said.
The organization is proposing pharmacotherapy for opioid use disorder as well. Research has shown that pharmacotherapy can improve outcomes for opioid use disorder, NCQA noted, and is critical to prevent relapse and overdose.
The committee is also proposing prenatal and postpartum depression screenings and follow-ups for those who screened positive. In addition, NCQA is seeking to update existing measures, including adherence to antipsychotic medications for patients with schizophrenia.
“Evidence supports antipsychotic medication adherence to avoid consequences such as greater risk of relapse, hospitalization and suicide. NCQA proposes to add the Medicare and commercial product lines, in addition to expanding the measure to include adults 19 years of age and older,” NCQA said.
The committee is also proposing structural changes that will improve inappropriate antibiotic prescribing, as well as cervical cancer screenings as a primary screening option.
Other updated measures include prenatal and postpartum care, use of opioids at high doses, and use of high-risk medications in the elderly.
NCQA also recommends that selected HEDIS physical health measures include telehealth, and is asking for stakeholder input on their digital measure strategy.
“NCQA seeks public comment on our approach to gradually add digital formats to HEDIS measures and to add the Electronic Clinical Data Systems reporting standard to three existing measures for voluntary reporting alongside traditional reporting: Breast Cancer Screening, Colorectal Cancer Screening and Follow-Up Care for Children Prescribed ADHD Medication,” NCQA said.
“These efforts are part of NCQA’s strategy to encourage clinical data exchange and to move toward measures that improve our ability to measure the quality of health care.”
The public comment period began on February 11, 2019, and ends at 11:59 PM on March 11, 2019. NCQA will review input from public comments and publish new measures in HEDIS 2020. To read and comment on proposed changes, please click here.