HEDIS Program 2018 Changes 01.12.2018 .pdf
Original filename: HEDIS Program_2018 Changes_01.12.2018.pdf
Title: HEDIS Program_2018 Changes_01.12.2018
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Highlights of new & changed 2018 HEDIS measures
NCQA’S SEVEN NEW QUALITY MEASURES
NCQA’S CHANGES TO EXISTING MEASURES
1. Transitions of Care: Assesses percentage of inpatient (IP) discharges for
Medicare members who had each of the following during the
1. Telehealth for Behavioral Health Measures:
Introduced telehealth in seven behavioral health
measures, such as allowing one follow-up visit to
occur via telehealth for children prescribed Attention
Deficit Hyperactivity Disorder (ADHD) medication.
Notification of IP Admission
Receipt of Discharge Information
Patient Engagement After IP Discharge
Medication Reconciliation Post-Discharge
2. Follow-up After Emergency Department (ED) Visit for Medicare members
with high-risk multiple chronic conditions (follow-up care within seven days
of ED visit)
3. Use of Opioids at High Dosage: Assesses rate of all health plan members
who receive long-term opioids at high dosage
2. Mental Health Utilization (MPT): Added telehealth
3. Plan All-Cause Readmissions: Added the Medicaid
4. Breast Cancer Screening: Added digital breast
tomosynthesis to numerator criteria
4. Use of Opioids from Multiple Providers: Rate of all health plan members
who receive opioids from multiple prescribers and multiple pharmacies
5. Depression screening and follow-up (if screened positive) for adolescents
6. Unhealthy Alcohol Use screening and follow-up within two months (if
7. Pneumococcal Vaccination Coverage for older adults
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