HEDIS Resources

HEDIS® (Healthcare Effectiveness Data and Information Set) is a standardized set of performance measurements developed by the National Committee for Quality Assurance (NCQA) for measuring quality health care performance. As a part of L. A. Care’s initiative to improve quality of care to our members, these HEDIS® reference guides for selected priority HEDIS® measures are designed to help your practice provide the best quality care, in alignment with the HEDIS® standards as well as with evidence-based clinical practice guidelines. These reference materials may also provide guidance on accurate and complete documentation as well as timely data submission to L. A. Care. Additionally, if you participate in and qualify for Physician Pay-for-Performance Program, these HEDIS® resources may help you maximize the incentives you receive as part of L. A. Care’s Physician Pay-for-Performance Program.

For any HEDIS® related inquiries, please email them to HEDISOps@lacare.org.

2016 Measure Criteria

HEDIS Measure Criteria (Guidance Documents):

HEDIS At a Glance

Adult BMI Assessment (ABA)

Antibiotic Treatment in Adults With Acute Bronchitis (AAB)

Follow-Up Care for Children Prescribed ADHD Medication (ADD)

Antidepressant Medication Management (AMM)

Anti-Rheumatic Drug Therapy for Rheumatoid Arthritis (ART)*

Adolescent Well-Care Visits (AWC)

Breast Cancer Screening (BCS)*

Controlling High Blood Pressure (CBP)*

Cervical Cancer Screening (CCS)

Comprehensive Diabetes Care (CDC)*

Chlamydia Screening in Women (CHL)

Childhood Immunization Status (CIS)

Care for Older Adults (COA)*

Colorectal Cancer Screening (COL)*

Appropriate Testing for Children with Pharyngitis (CWP)

Frequency of Ongoing Prenatal Care (FPC)

Human Papillomavirus Vaccine for Female Adolescents (HPV)

Engagement of Alcohol and Other Drug Dependence Treatment (IET)

Immunizations for Adolescents (IMA)

Use of Imaging Studies for Low Back Pain (LBP)

Lead Screening in Children (LSC)

Medication Management for People With Asthma (MMA)

Annual Monitoring for Patients on Persistent Medication (MPM)

Medication Reconciliation Post-Discharge (MRP)

Osteoporosis Management in Women Who Had a Fracture (OMW)*

Pharmacotherapy Management of COPD Exacerbation (PCE)*

Prenatal and Postpartum Care (PPC)

Spirometry Testing in the Assessment and Diagnosis of COPD (SPR)

Treatment for Children with Upper Respiratory Infection (URI)

Well-Child Visits in the First 15 Months of Life (W15)

Well-Child Visits in the Third, Fourth, Fifth, and Sixth Years of Life (W34)

Nutrition & Physical Activity for Children and Adolescents (WCC)

                                                                                                                                        *Medicare Star Program

HEDIS 2016 Value Set Analysis

 

2017 Measure Criteria

HEDIS Measure Criteria (Guidance Documents):

HEDIS at a Glance

Adult BMI Assessment (ABA)

Antibiotic Treatment in Adults With Acute Bronchitis (AAB)

Follow-Up Care for Children Prescribed ADHD Medication (ADD)

Antidepressant Medication Management (AMM)

Anti-Rheumatic Drug Therapy for Rheumatoid Arthritis (ART)*

Adolescent Well-Care Visits (AWC)

Breast Cancer Screening (BCS)*

Controlling High Blood Pressure (CBP)*

Cervical Cancer Screening (CCS)

Comprehensive Diabetes Care (CDC)*

Chlamydia Screening in Women (CHL)

Childhood Immunization Status (CIS)

Care for Older Adults (COA)*

Colorectal Cancer Screening (COL)*

Appropriate Testing for Children with Pharyngitis (CWP)

Frequency of Ongoing Prenatal Care (FPC)

Engagement of Alcohol and Other Drug Dependence Treatment (IET)

Immunizations for Adolescents (IMA)

Use of Imaging Studies for Low Back Pain (LBP)

Lead Screening in Children (LSC)

Medication Management for People With Asthma (MMA)

Annual Monitoring for Patients on Persistent Medication (MPM)

Medication Reconciliation Post-Discharge (MRP)

Osteoporosis Management in Women Who Had a Fracture (OMW)*

Pharmacotherapy Management of COPD Exacerbation (PCE)*

Prenatal and Postpartum Care (PPC)

Spirometry Testing in the Assessment and Diagnosis of COPD (SPR)

Treatment for Children with Upper Respiratory Infection (URI)

Well-Child Visits in the First 15 Months of Life (W15)

Well-Child Visits in the Third, Fourth, Fifth, and Sixth Years of Life (W34)

Nutrition & Physical Activity for Children and Adolescents (WCC)

                                                                                                                                        *Medicare Star Program

HEDIS 2017 Value Set Analysis