The department intends to contact with an aso through a competitive bidding process to provide certain specified administrative services necessary to manage alaska s behavioral health system of care on the departments behalf. Hedis hedis is a set of standardized measures used to evaluate performance in the health care industry. Preventive care, chronic disease management, perinatal care, and behavioral health care. The healthcare effectiveness data and information set hedis is a set of nationally recognized performance measures developed and maintained by the national committee for quality assurance ncqa. It also shows the overall 2015 statewide average hedis results for medicaid. Regional mean is the average score for all ppo plans in alaska, idaho, oregon and washington. Healthcare effectiveness data and information set hedis hedis is a set of standardized performance measures designed to ensure that the public including employers, the centers for medicare and. In 2016, the cdc announced new recommendations for the hpv vaccine. Hedis is a comprehensive set of standardized performance measures designed to provide purchasers and consumers with the information they need for reliable comparison of health plan performance. For webinar, please use the following information on your computer.
Masshealth hedis 2016 measures masshealth selected 14 measures for the hedis 2016 report. With your help, aetna better health of texas has experienced an. Members discharged for cabg during 2016 or the year prior. Hedis 2017 is published across a number of volumes and includes 91 measures. Kaiser is the highest scoring network on most measures. Bh hedis measures used to measure provider performance i. All template totals match totals reported in the hedis interactive data submission system idss. We selected 22 measures for the analysis that were reported by ma organizations to cms in 20 and used to generate the 2014 star ratings see table s1 for a description of each measure. Measurements reflect care and service provided in 2008. Black or african american hispanic or latino hedis numerator administrative specifications for hba1c control alaska native, not hispanic or latino asian, not hispanic or latino. Aetna life insurance company arizona hedis 2016 quality.
Hedis healthcare effectiveness data and information set is one tool we use to measure many aspects of performance. Covered california will assess these two approaches during the baseline measurement years 2015 and 2016 and anticipates a smaller set of measures for measurement year 2017. Onehalf of the quality measures selected six out of the twelve are in the. Hedis measures select examples how can you improve your hedis scores. Hedis 2020 quick reference guide coordinated care health.
Reporting hedis rates hedis measures evaluate the previous years clinical data. Ncqa develops hedis measures through a committee represented by purchasers. Healthcare effectiveness data and information set hedis. Hedis measures relate to many significant public health issues, such as cancer, heart disease, smoking, asthma, and diabetes. Hedis is a comprehensive set of standardized performance measures designed to provide purchasers and consumers with the information they need.
Weight assessment and counseling for nutrition and physical activity for childrenadolescents. Medicare beneficiaries 65 and older with balance or walking problems or a fall in the past 12 months, who were seen by a practitioner in the past 12 months and who report discussing falls or problems with balance or walking with the practitioner. Premera blue cross network news blue shield of alaska. Who is the michigan quality improvement consortium. Black or african american hispanic or latino qrs hedis numerator administrative specifications for hba1c control. The healthcare effectiveness data and information set hedis consists of a set of performance measures developed by the national committee for quality assurance ncqa, and is used by more than 90 percent of american health plans to compare how well a plan performs in these areas. Twelve of these 14 measures assess the quality of health care in four domains. Your 2016 guide to key hedis measures keywords healthcare effectiveness data and information set hedis measures help keystone first monitor care and identify opportunities to improve access to preventive and recommended services. At least two vaccines administered with a date of service on or between the members 11th and th birthdays.
Thoroughly documenting and coding patient screenings helps us. These newly expanded demographic measures, combined with the selfreported health status measures captured by the hos, provide a rich source of data that may be useful for research. Magnolia health strives to provide quality healthcare to our membership as measured through hedis quality metrics. Hedisataglance is a reference guide designed to help your practice provide the best quality care, in alignment with the hedis standards. Hedis measures central california alliance for health coding requirements. No license is required for noncommercial uses of the measures to report quality data under the. Providers play a critical role in the outcome of hedis measures. Documentation with the most recent hba1c test performed during 2016. Aso to manage the medicaid supported behavioral health system of care in alaska. Healthcare effectiveness data information set hedis date. This section includes measure specifications and data.
Ncqa accredits and certifies a wide range of health care organizations, recognizes physicians and physician groups in key clinical areas and manages the evolution of hedis, the tool the nation. Included in these reports are some of our hedis 2009 effectiveness of care measures as well as a measure on access to care. They were above the high performance level national medicaid 90th percentile on 19 measures and were below the minimum performance level national medicaid 25th percentile on one. Jan 24, 2019 predictors of healthcare effectiveness data and information set hedis treatment initiation and engagement among patients with opioid use disorder across 7 health systems. Hedis annual timeline hipaa and hedis what is the providers role in hedis.
Predictors of healthcare effectiveness data and information set hedis treatment initiation and engagement among patients with opioid use disorder across 7 health systems. For clinical effectiveness of care measures of performance. Hedis 2016 texas department of state health services. Ncqa is a nonprofit organization dedicated to improving health care quality. Office of minority health hos data brief on asian americans and pacific islanders pdf, 208 kb 2015. Thank you for your interest in this provider education which is designed to assist your practice in improving hedis scores and star ratings. Quality measures desktop reference for medicaid providers. Anyone desiring to use or reproduce the materials, subject to. This section includes measure specifications and data collection guidelines for ncqas hedis measures and the pqa measure in the qrs measure set. For ages 3 months and older who were given a diagnosis of uri and not prescribed an antibiotic. Healthcare effectiveness data and information set hedis measures help keystone first monitor care and identify opportunities to improve access to preventive and recommended services. Hedis ataglance is a reference guide designed to help your practice provide the best quality care, in alignment with the hedis standards.
Measures collected through cahps health plan survey. The percentage of women 1624 years of age who were identified as sexually active and who had at least one test for chlamydia during the measurement year. Michigan quality improvement consortium detailed measurement. Hedis quick reference guide updated to reflect ncqa hedis 2016 technical specifications mhs health wisconsin strives to provide quality healthcare to our membership as measured through hedis quality metrics. May 03, 2016 well as separately reported pqi measures. Hedis healthcare efectiveness data and information set is a set of standardized performance measures developed by the national committee for quality assurance ncqa to objectively measure, report, and compare quality across health plans. The following table shows our aetna better health of texas hedis results from 2015 to 2016. Adult bmi assessment aba weight assessment and counseling for nutrition and physical activity for childrenadolescents. Pcp hedis quick reference guide universal american.
Manage your healthcare outcomes aapc knowledge center. The ma program performance was higher than the snp program performance for 22 of 28 measures in 2016, with significant differences for 14 of these measures. Hedis is a set of standardized measures that specifies how. Hedis the healthcare effectiveness data and information set is the gold standard in health care performance measurement, used by more than 90 percent of the nations health plans and many leading employers and regulators. Colorectal cancer screening col we are committed to working with you to improve the quality of care and health outcomes for our members, your patients. This document details some of the key features of the hedis. The two components of this survey measure assess different facets of fall risk management. The michigan quality improvement consortium mqic is a group of physicians, administrators, researchers, and quality improvement experts from michigan. Of this total, 16 were clinical quality measures, including 10 healthcare effectiveness data and information set hedis measures five measures for which administrative. Hedis 2017 guidelines 4 wellchild visits in the third, fourth, fifth and sixth years of age hedis 2017 guidelines members who are 3 to 6 years of age as of december 31, 2016 and who receive one or more wellchild visits between january 1, 2016 and december 31, 2016. Chlamydia is the most commonly reported bacterial sexually transmitted disease in the united states.
See table 1 for a list of the hedis measures included in 2016. Once ciox verifies your fax number and schedules a retrieval. It occurs most often among adolescent and young adult females. The 2016 hedis measures for qrs contained in this document are ed by ncqa and are reprinted herein with the permission of ncqa. About the hedis 2016 measures reporting year 2015 hedis healthcare effectiveness data and information set is a set of performance measures developed by the national committee for quality assurance ncqa. We created the hedis quick reference guide to help you increase your practices hedis rates. State of alaska department of health and social services. Cahps survey a component of hedis how can aetna better. Hedis provider premera blue cross blue shield of alaska.
Users of the hedis measures and specifcations shall not have the right to alter, enhance or otherwise modify the hedis measures and specifcations, and shall not disassemble, recompile or reverse engineer the hedis measures and specifcations. Hedis measures performance in health care where improvements can make a meaningful difference in peoples lives. Ncqa has expanded the size and scope of hedis to include measures for physicians, ppos and other organizations. Measures collected using electronic clinical data systems. Hedis is a set of standardized performance measures that ensure consumers have the. Hedis includes more than 90 measures across 6 domains of care. Hedis measures healthcare effectiveness data and information set measures hmo health maintenance organization.
Updated to refect ncqa hedis 2020 technical specifcations. Quality measures desktop reference for medicaid providers please note. Pdf predictors of healthcare effectiveness data and. Health plans used their audited hedis data to draw the initial numbers total numerators and denominators, but the final data broken down by raceethnicity is not audited. Snps report a subset of the full ma hedis measures set, so this report compares only the measures that are commonly report at the snp benefitpackage level and the ma contractlevel. Hedis is the gold standard for measuring quality health care performance, and is part of the ncqa accreditation process. Listed codes are examples acceptable for hedis 919 appropriate treatment for with uri. Ncqa established healthcare effectiveness data and information set hedis measures specifically for snps. For example, most hedis rates reported in 2016 are based on clinical services performed in 2015. Aim to enhance quality of care and reduce costs by meeting performance measures and three criteria. Hedis is a set of standardized measures that specifies how organizations collect, audit and report performance. A mistake by it resulted in two of their measures being artificially low.