HEDIS®1 2016 Public Comment Overview

Draft Document for HEDIS 2016 Public Comment—Obsolete After March 18, 2015
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HEDIS®1 2016 Public Comment Overview
HEDIS Overview
HEDIS is a set of standardized performance measures designed to ensure that purchasers and consumers
can reliably compare the performance of health plans. It also serves as a model for emerging systems of
performance measurement in other areas of health care delivery.
HEDIS is maintained by NCQA, a not-for-profit organization committed to evaluating and publicly reporting on
the quality of physicians, HMOs, PPOs, ACOs and other organizations. The HEDIS measurement set
consists of 83 measures across five domains of care. Items available for Public Comment are proposed
changes to HEDIS 2016, which will be published in July 2015 and reported in June 2016, based on activity
that occurred during the 2015 measurement year.
HEDIS Measure Development Process
The NCQA Committee on Performance Measurement (CPM) oversees the evolution of the measurement set.
Several Measurement Advisory Panels (MAP) provide clinical and technical knowledge required to develop
the measures. Additional HEDIS Expert Panels and the Technical Measurement Advisory Panel (TMAP)
provide invaluable assistance by identifying methodological issues and providing feedback on new and
existing measures.
Synopsis
NCQA seeks feedback on proposed new measures and changes to specifications and guidelines for HEDIS
2016. Reviewers are asked to submit their comments to NCQA in writing via the Public Comment Web site by
5:00 PM (EST) Wednesday, March 18.
Submitting Comments
Submit all comments via NCQA’s Public Comment Web site, using the following link:
www.ncqa.org/publiccomment.aspx
Note: NCQA does not accept comments via mail, e-mail or fax.
How to Submit a Comment
1. Enter the following information:
 Your e-mail address.
 Your contact information.
2. Choose from the following options:
 Select HEDIS 2016 Public Comment.
 Select the measure on which you would like to comment.
 Select your support option (e.g., Support, Do not support, Support with modifications).
Note: If you choose Do not support, include your rationale in the text box. If you choose Support with
modifications, enter the suggested modification in the text box.
©2015 National Committee for Quality Assurance
Draft Document for HEDIS 2016 Public Comment—Obsolete After March 18, 2015
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3. Enter your comment into the text box. There is a 2,500 character limit. If you exceed the limit, your
comment will be cut off at 2,500 characters.
Note: We suggest that you develop your comment in Word, in order to check your character limit, and
save a copy for reference. Use the “cut and paste” function to copy your comment into the text box.
4. Submit additional comments using the same process.
NCQA must receive your comments by 5:00 PM (EST) Wednesday, March 18.
Note: For more detailed information on posting a comment, please see “Posting a Comment Instructions”
document.
NCQA Review of Public Comments
NCQA appreciates the time and effort required to submit comments, and reviews all feedback submitted
within the Public Comment period. Due to the high volume of comments received, NCQA cannot respond to
individual comments; however, NCQA MAPs and Expert Panels will consider all comments and advise NCQA
staff.
Based on the review, NCQA staff will bring recommendations to the CPM, a committee of representatives
from purchasers, consumers, health plans, health care providers and policy makers that oversees the
evolution of the measurement set. The CPM also reviews all comments before making final decisions for
HEDIS 2016.
Value Set Directory
Effective with HEDIS 2014, code tables are not included in measure specifications; they are included in a
separate Excel workbook called the “Value Set Directory.” Measure specifications reference value sets that
must be used for HEDIS reporting.
A value set contains the complete set of codes used to identify the service or condition included in the
measure. All codes for all measures listed below are in the HEDIS 2016 Public Comment Value Set Directory,
which is included with the measure materials on the NCQA Public Comment Web page.
Items for Public Comment
Refer to the NCQA Public Comment page for detailed documentation (e.g., memos, specifications, workups,
performance data, guidelines, value sets) on the items described below.
Proposed New Measures
NCQA proposes the following new measures:
1. Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults.
2. Depression Remission, Response or Treatment Adjustment for Adolescents and Adults.
3. Depression Screening and Follow-up for Adolescents and Adults.
4. Inpatient Hospital Utilization.
5. Emergency Department Utilization.
6. Statin Therapy for Patients with Cardiovascular Disease.
7. Statin Therapy for Patients with Diabetes.
©2015 National Committee for Quality Assurance
Draft Document for HEDIS 2016 Public Comment—Obsolete After March 18, 2015
8. Hospitalization for Potentially Preventable Complications.
Proposed Changes to Existing Measures
NCQA proposes changes to the following measures:
1. Asthma Medication Ratio.
2. Medication Management for People with Asthma.
3. Medication Reconciliation Post-Discharge.
Proposed Measures to Retire
NCQA proposes retiring the following measures:
1. Use of Appropriate Medications for People with Asthma.
Guideline Updates
NCQA would like feedback on the following guideline updates:
1. General Guideline 28: Members who Switch Products.
2. Guidelines for Relative Resource Use Measures
Guideline Announcement
NCQA would like to announce the following guideline retirement:
1. General Guidelines 12–16: Retirement of the Measure Rotation Strategy.
Questions?
Contact NCQA Customer Support at 888-275-7585, Monday–Friday, 8:30 a.m.–5:00p.m. (EST).
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1HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
©2015 National Committee for Quality Assurance
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