This comprehensive report is available online in pdf format on the arhs. Hedis quick reference guide updated to reflect ncqa hedis 2018 technical specifications what is hedis. Outpatient quality measures health effectiveness data information set hedis for 2015 q3. The 2016 hedis measures for qrs contained in this document are. The college of the albemarle coa is a community college that serves. I am pleased to present to you dhs 201617 annual report.
Hedis quick reference guide updated to relect ncqa hedis 2016 technical speciications. The healthcare effectiveness data and information set hedis is a tool that helps health plans measure the quality of care their members receive. It is our goal that the 2016 health of the force will facilitate informed. Anyone desiring to use or reproduce the materials, subject to. Aetna life insurance company arizona hedis 2016 quality. Key ways blue cross blue shield raises its hedis scores we have contracts that are based on quality measures and we have. We created the hedis quick reference guide to help you increase your practices hedis rates. 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. This oneday seminar is designed for the participant experienced in the hedis process. For hedis 2016, dhmh required healthchoice managed care organizations to report the complete. Hedis is a nationally standardized set of measures related to important areas of care and service.
For ages 3 months and older who were given a diagnosis of uri and not prescribed an antibiotic. No license is required for noncommercial uses of the measures to report quality data under the. The 2016 hedis measures for qrs contained in this document are ed by ncqa and are reprinted herein with the permission of ncqa. That makes hedis one of health care s most widely used performance improvement tools. 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. For hedis 2016 the bmi and bmi percentile numerator age criteria. Hedis measure memberdescription documentation requirements codes. The michigan quality improvement consortium mqic is a group of physicians, administrators, researchers, and quality improvement experts from michigan. 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. Hedis gives purchasers, physicians and consumers standardized information.
Hedis quick reference guide updated to reflect ncqa hedis 2017 technical specifications what is hedis. Quality measures desktop reference for medicaid providers please note. Your 2016 guide to key hedis measures keystone first. Hedis is a set of standardized performance measures developed by the national committee for quality assurance ncqa which allows comparison across health plans. In 2016, mississippi announced a partnership with the. Quality measures desktop reference for medicaid providers. To make the most of yo ur office visits towards meeting hedis measures, please document the following criteria as applicable. Hedis measures and specifications are not clinical guidelines and do not establish a standard of medical care, and have not been.
Hedis performance measures peach state health plan. Visitors to this page often check hedis faqs, qrs faqs, or ask a question through myncqa. Aco reporting and related incentives are becoming extremely important for healthcare providers in the us. Each year, utah hmos report hedis measures to the utah department of health. The 2017 national wheelchair basketball tourna ment was. Hedis measure set for services rendered in calendar year. Hedis is a set of standardized measures that specifies how. Hedis was developed and is maintained on an annual.
Health care innovation awards diseasespecific evaluation cms. Buckeye uses hedis data to identify areas for improvement and monitor progress. The 2018 ncqas quality measures for hedis were published in autumn 2017. Health of the force report 2016 army public health center. Adult bmi assessment aba weight assessment and counseling for nutrition and physical activity for childrenadolescents. Measure short description and title as used in sfhps practice improvement program pip ncqa hedis measure abbreviation some measures have multiple services required labeled here as indicators industry standard alphanumeric representation of service. Healthcare effectiveness data and information set hedis measures help keystone first monitor care and identify opportunities to improve access to preventive and recommended services. A guide to understanding medicaid measure compliance. This is done by looking at the type of care and services provided. Louisiana healthcare connections will refine and analyze these measures in 2016 for ongoing progress. Once ciox verifies your fax number and schedules a retrieval dates, you will receive a provider package that contains. Measures collected through cahps health plan survey. Proportion of days covered by medications pdc and highrisk medication hrm.
Assesses children and adolescents 317 years of age who had an outpatient visit with a primary care practitioner or obgyn during the measurement year and had evidence of. That makes hedis one of health cares most widely used performance improvement tools. Body mass index bmi percentile documentation, counseling for nutrition, and counseling for physical activity. Drugs to identify members on ace inhibitors or arbs cdcl. The quality improvement provider resource guide and toolkit is designed to provide health plan network primary care providers pcp with information on quality measures and what they mean to the health plan. Snps reported the following measures in hedis 2016. Listed codes are examples acceptable for hedis 919 appropriate treatment for with uri. 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. Through hedis, ncqa holds peach state health plan accountable for the timeliness and quality of healthcare services acute, preventive, mental health, etc delivered to its diverse. Measures collected using electronic clinical data systems. Statewide executive summary hedis 2016 maryland medicaid. Hedis healthcare effectiveness data and information set is a set of standardized performance measures developed by the national committee for quality assurance. Magnolia health strives to provide quality healthcare to our membership as measured through hedis quality metrics.
Hedis is a retrospective process hedis 2017 calendar year 2016 data hedis is a yearround effort. Hedis includes measures for physicians, ppos and other organizations. But i was wondering if you could tell me the pro and cons of selecting either edd vs dod for the hybrid collection for the ppc timeliness of prenatal care. Hedis measures summary 2018 horizon blue cross blue. Key ways blue cross blue shield raises its hedis scores.
This section includes measure specifications and data. Hedis is a set of standardized measures that specifies how organizations collect, audit and report performance information across the most pressing clinical areas, as well as important dimensions of customer satisfaction and patient experience. Each year, blue cross and blue shield of illinois bcbsil reports audited health care effectiveness data and information set hedis results. The 2016 measures reflect performance for the 2015 calendar year. 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.
Weight assessment and counseling for nutrition and. Cms has released 33 aco quality measures that need to be reported which is very effort and cost intensive for healthcare organizations. Use your member roster to contact patients who are due for an exam or are new to your practice take advantage of this guide, coding information, and the online resources to help your practice understand hedis measures, compliance, and requirements. Hedis is the gold standard for measuring quality health care performance, and is part of the ncqa accreditation process. Health plans nationwide collect these measures to see how they performed in different areas of health care over the past year. Hedis includes more than 90 measures across 6 domains of care. 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. The healthcare effectiveness data and information set hedis 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. Some measures, such as cervical cancer screening, look for services performed up to 5 years prior to the reporting year. Healthcare effectiveness data and information set hedis cms.
This document details some of the key features of the hedis. Hedis healthcare effectiveness 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. Because bmi norms for youth vary with age and gender, this measure evaluates whether bmi percentile is assessed. Set hedis performance indicators for beneficiaries enrolled to the installation. Two lighted tennis courts, lighted basketball courts, 5 lighted ball fields 3. Controlling high blood pressure is an important step in preventing heart attacks, stroke and kidney disease, and in reducing the risk of developing other serious conditions.
Who is the michigan quality improvement consortium. Below are the 2014 results of the stateselected measures. Healthcare effectiveness data and information set hedis. Hedisataglance is a reference guide designed to help your practice provide the best quality care, in alignment with the hedis standards. Cms billing guidance and ensure the hedis codes are covered prior to submission. Sunshine health strives to provide quality healthcare to our membership as measured through hedis quality metrics. Louisiana healthcare connections uses hedis data to identify areas for improvement and monitor ongoing initiatives. General tips and information that can be applied to most hedis measures. Kaiser is the highest scoring network on most measures. These are the measures and standards that ahca, like most managed care organizations, uses to help. Performance measure data submissions for medicaid ahca. 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 2019 physician documentation guidelines and administrative codes. Hedis measuresa doctor providersierra health and life.
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