New HEDIS Measures for 2019 The newest additions to HEDIS address emerging health priorities and evolving processes in care delivery. NCQA accredits and certifies health care organizations and recognizes clinicians and practices. 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.

A quick and easy reference containing the most current information, measure descriptions, and tips to help improve rates of compliance. HEDIS Measure Documentation Tips Sample Codes Used VISITS Dental Visit (ADV) At least one dental visit during the measurement year.

To ensure the integrity of HEDIS and CAHPS data, NCQA requires that health plans use an NCQA-certified third party vendor to administer the survey. KEY PEDIATRIC MEASURES 2019 HEDIS® AT-A-GLANCE: Operated by WellCare. The measures allow consumers to compare health plan performance to other plans and to national or regional benchmarks.

Breast Cancer Screening. HEDIS is a widely used set of outpatient performance measures. 2020 HEDIS ® measures.

HEDIS is one component of the National Committee for Quality Assurance’s (NCQA) accreditation process.

for HEDIS® Program measures and guidelines as well as relevant statutes. For HEDIS 2019, the following nine measures exclude individuals 65 and older who have an advanced illness and frailty or who live long-term in nursing home settings.

HEDIS 2019 Rating Color and Measure Designations ..... 37 Table 5a. At WellCare, we value everything you do to deliver quality care to our members – your patients – and to make sure they have a positive healthcare experience.

Th e information provided in this document is for 2019 HEDIS® period and is current at the time this document was created. HEDIS Measures relate to many significant public health issues, such as cancer, heart disease, smoking, asthma, and diabetes. * HEDIS 2020 (July 2019 release) — 25 measures; HEDIS 2021 (July 2020 release) — 50 measures; HEDIS 2022 (July 2021 release) — 55 measures For commercial and Medicaid plans reporting to NCQA, for measures reported using the hybrid methodology only, we will allow plans to report their audited HEDIS 2019 hybrid rate if it is better than their HEDIS 2020 hybrid rate as a result of low chart retrieval. NCQA HEDIS® Program requirements, applicable laws, and L.A. Care’s policy There are more than 90 current measures that span six domains of care and evaluate if health plans are providing necessary care related to issues including medication adherence, chronic disease …



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