|[February 21, 2013]
NCQA Seeks Input on New and Revised Measures
WASHINGTON --(Business Wire)--
The National Committee for Quality Assurance (NCQA) invites the public
to comment on its 2014 Healthcare Effectiveness Data and Information Set
(HEDIS®) measures. This is an opportunity for health plans,
purchasers, consumers and other stakeholders to ensure that new and
existing measures are relevant, scientifically sound and feasible.
This year, NCQA proposes one new measure, Inappropriate Cervical
Cancer Screening in Adolescent Females; reevaluates several existing
measures, including Breast Cancer Screening; and makes changes to
the Effectiveness of Care measures.
About HEDIS and Public Comment
NCQA produces the Healthcare Effectiveness Data and Information Set
(HEDIS). These are measures of clinical quality and patient experience
that are supported by the best available scientific evidence on what
works in healthcare. NCQA creates new HEDIS measures and updates
existing measures when new evidence becomes available in the scientific
literature. NCQA convenes multi-stakeholder groups (made up of
scientists, clinicians, consumers and purchasers) to ensure that the
measures meet the high standards of relevance, scientific soundness and
Purchasers use HEDIS measures. Examples of initiatives that include
HEDIS are Medicare's star rating system for health plans, the eValu8
system for employer coalitions, many Medicaid programs and state
insurance departments. The measures are used to monitor health plan
performance, choose among plans and in some initiatives as the basis for
Because of these uses of HEDIS data, NCQA works very carefully to only
include in HEDIS measures that reflect strong evidence that provides a
clear signal on what constitutes good quality.
An important part of developing and updating HEDIS measures is the
opportunity for the public to review a measure and offer support,
recommend changes or ask for clarification. NCQA reviews every comment,
synthesizes themes and presents comments to the Committee on Performance
Measurement for deliberation. NCQA relies on information received during
Public Comment to ensure that the final measure meets the criteria of
relevance, scientific soundness and feasibility.
Note that HEDIS and NCQA do not set coverage or benefit policy.
Proposed New Measure
Inappropriate Cervical Cancer Screening in Adolescent Females: NCQA
proposes to assess the number of adolescents 16-20 years of age who have
not been screened for cervical cancer, in accordance with U.S.
Preventive Services Task Force (USPSTF) guidelines, which recommend
against screening for women under 21.
Breast Cancer Screening:
Cervical Cancer Screening: NCQA proposes incorporating
cytology/human papillomavirus (HPV) co-testing into the Cervical
Cancer Screening measure. This new test, used in combination with
Pap test, is recommended by the USPSTF and can be used for a subset of
women (women 30-65 years of age who prefer this test over the
traditional Pap test alone).
Childhood Immunization Status: This measure monitors whether
children under 2 years of age get necessary vaccines to protect
against disease. NCQA proposes to assess whether a child
receives at least one of two required hepatitis A vaccines by the
second birthday, in order to accurately reflect the timing recommended
by the Advisory Committee on Immunization Practices (ACIP).
Management of Urinary Incontinence in Older Adults: This
measure assesses how many Medicare adults age 65 and older have
problems with urinary incontinence (UI), discussed their incontinence
with their current practitioner and received treatment. NCQA proposes
to improve the measure's accuracy by updating the survey questions,
changing an indicator to assess discussion of UI treatment and
creating a new indicator to examine the impact of UI on daily
activities and sleep.
Potentially Harmful Drug-Disease Interactions in the Elderly:
This measure assesses the number of Medicare adults age 65 and older
with specific conditions, who were prescribed one or more potentially
harmful medications. NCQA is updating this measure to align with the
recently published 2012 American Geriatrics Society Updated Beers
Criteria for Potentially Inappropriate Medication Use in Older Adults.
The update adds several new, potentially harmful medications.
Care for Older Adults: This measure shows how many Medicare
adults 65 and older had each of the following during the measurement
year: pain screening, medication review, advanced care planning and
functional status assessment. Proposed changes focus on the
pain-screening indicator, renamed "pain assessment," and clarify the
definition of pain assessment.
Flu Shots for Older Adults /Flu Shots for Adults Ages 50-64: This
survey measure currently captures self-reported flu vaccination rates
for adults 50-64 years of age. NCQA proposes to expand the age range
to include adults 18-49, in order to align with ACIP recommendations
that all adults receive an annual flu vaccination. The expanded age
range requires the survey question to be revised to refer to multiple
forms of flu vaccinations. The revised question will also ask about
flu vaccinations received since July, as opposed to September, to
reflect the earlier availability of the vaccination. To complement
these changes, NCQA proposes changing the measure name to Flu
Vaccinations for Adults Ages 18-64. NCQA is also proposing
to rename the "Flu Shots for Older Adults" measure to "Flu
Vaccinations for Adults Ages 65 and Older" and changing the date
in the measure to July.
Relative Resource Use: NCQA proposes changes to the RRU
measures that will assess use of health care services more precisely
and allow more plans to publicly report results. Changes will lower
the eligible population size requirement to 200 across all RRU
measures; remove ESRD and kidney transplant exclusions from the
Diabetes and Cardiovascular Conditions measures; and expand the Asthma
quality composite to include the new measures Medication Management
for People With Asthma and Asthma Medication Ratio.
Proposed Changes to a Measure
Guidelines for Effectiveness of Care Measures: Proposed changes
will allow organizations to choose whether to include reversed claims
when reporting services and events for Effectiveness of Care measures.
How to Participate in Public Comment
To read and comment on the proposed changes, visit www.ncqa.org/publiccomments.aspx.
The public comment period begins at 9 a.m. ET on February 21 and ends at
5 p.m. ET on March 21, 2013. NCQA will review input from Public Comment
and will publish new and updated measures in HEDIS 2014, Volume 2, in
NCQA is a private, non-profit organization dedicated to improving health
care quality. NCQA accredits and certifies a wide range of health care
organizations. It also recognizes clinicians and practices in key areas
of performance. NCQA is committed to providing health care quality
information for consumers, purchasers, health care providers and
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