AdobeStock_135683672
Jul 27, 2018

NCQA Issues New and Revised Quality Measures for 2019

NCQA has issued new technical specifications for the 2019 edition of the Healthcare Effectiveness Data and Information Set (HEDIS®), featuring four new measures and changes to four current measures. The updates are intended to address emerging health priorities and evolving processes in care delivery.

New measures introduced
     
• Reflecting the opioid crisis, a new measure tracks the risk of continued opioid use for members 18 years and older who have a new episode of opioid use that puts them at risk.
     • Hospitalization following discharge from a skilled nursing facility at 30- and 60-day intervals following discharge is a new measure for Medicare Advantage plans 
     • Two new measures address prenatal and adult immunization.

Modification of current measures
     • Among several changes to existing measures are two for follow-up after emergency room and hospitalization encounters related to mental illness. 

NCQA introduced telehealth into 14 existing physical health measures for HEDIS 2019, following on previous work to add telehealth services to behavioral health measures last year. Other changes reflected NCQA intent to remove those with advanced illness from certain measures.

For more detail, read the press release from NCQA.