Health Effectiveness Data and Information Set (HEDIS) 2018 - Coming Soon

Here is the list of HEDIS measures for 2018.

C = Commercial, MCD – Medicaid and MCR = Medicare

PREVENTION AND SCREENING

• ABA – (C, MCD, MCR) - Adult BMI Assessment.
• WCC – (C, MCD) - Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents.
• CIS – (C, MCD) – Childhood Immunization Status.
• IMA – (C, MCD) – Immunizations for Adolescents.
• LSC – (MCD) – Lead Screening in Children.
• BCS – (C, MCD, MCR) – Breast Cancer Screening.
• CCS – (C, MCD) – Cervical Cancer Screening.
• COL – (C, MCR) – Colorectal Cancer Screening.
• CHL – (C, MCD) – Chlamydia Screening for Women.
• COA – (MCR) – Care for Older Adult.

RESPIRATORY CONDITIONS

• CWP – (C, MCD) – Appropriate Testing for Children with Pharyngitis.
• SPR – (C, MCD, MCR) – Use of Spirometry Testing in the Assessment and Diagnosis of COPD.
• PCE – (C, MCD, MCR) – Pharmacotherapy Management of COPD Exacerbation.
• MMA – (C, MCD) – Medication Management for People with Asthma.
• AMR – (C, MCD) – Asthma Medication Ratio.

CARDIOVASCULAR CONDITIONS

• CBP – (C, MCD, MCR) – Controlling High Blood Pressure.
• PBH - (C, MCD, MCR) – Persistence of Beta-Blocker Treatment After a Heart Attack.
• SPC – (C, MCR, MCD) – Statin Therapy for Patients with Cardiovascular Disease.

MEDICAL MANAGEMENT AND CARE COORDINATION

• MPM – (C, MCD, MCR) – Annual Monitoring for Patients on Persistent Medications.
• MRP – (MCR) – Medication Reconciliation Post-Discharge.
• ** NEW - TRC – (MCR) – Transitions of Care.
• ** NEW - FMC – (MCR) – Follow-up After Emergency Department Visit for People with High-Risk Multiple Chronic Conditions.

DIABETES

• CDC – (C, MCD, MCR) – Comprehensive Diabetes Care.
• SPD – (C, MCD, MCR) – Statin Therapy for Patients with Diabetes.

MUSCULOSKELETAL CONDITIONS

• ART – (C, MCD, MCR) – Disease-Modifying Anti-Rheumatic Drug Therapy for Rheumatoid Arthritis.
• OMW – (MCR) – Osteoporosis Management in Women who had a Fracture.

ACCESS AND AVAILABILITY OF CARE

• AAP – (C, MCD, MCR) – Adults’ Access to Preventive/Ambulatory Health Services.
• CAP – (C, MCD) – Children and Adolescents’ Access to Primary Care Practitioners.
• ADV – (MCD) – Annual Dental Visit.
• IET – (C, MCD, MCR) – Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment.
• PPC – (C, MCD) – Prenatal and Postpartum Care.
• APP – (C, MCD) – Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics.

OVERUSE AND APPROPRIATENESS

• NCS – (C, MCD) – Non-Recommended Cervical Cancer Screening in Adolescent Females.
• PSA – (MCR) – Non-Recommended PSA-Based Screening in Older Men.
• URI – (C, MCD) – Appropriate Treatment for Children with Upper Respiratory Infection.
• AAB – (C, MCD) – Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis.
• LBP – (C, MCD) – Use of Imaging Studies for Low Back Pain.
• APC – (C, MCD) – Use of Multiple Concurrent Antipsychotics in Children and Adolescents.
• DDE – (MCR) – Potentially Harmful Drug-Disease Interactions in the Elderly.
• DAE – (MCR) – Use of High-Risk Medications in the Elderly.
•  ** NEW - UOD – (C, MCD, MCR) – Use of Opioids at High Dosage.
• ** NEW - UOP – (C, MCD, MCR) – Use of Opioids from Multiple Providers.

BEHAVIORAL HEALTH

• AMM – (C, MCD, MCR) – Antidepressant Medication Management.
• ADD – (C, MCD) – Follow-up Care for Children Prescribed ADHD Medication.
• FUH – (C, MCD, MCR) – Follow-up After Hospitalization for Mental Illness.
• FUM – (C, MCD, MCR) – Follow-up After Emergency Department Visit for Mental Illness.
• FUA – (C, MCD, MCR) – Follow-up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence. 
• SSD – (MCD) – Diabetes Screening for People with Schizophrenia or Bipolar Disorder who are Using Antipsychotic Medications.
• SMD – (MCD) – Diabetes Monitoring for People with Diabetes and Schizophrenia.
• SMC – (MCD) – Cardiovascular Monitoring for People with Cardiovascular Disease and Schizophrenia.
• SAA – (MCD) – Adherence to Antipsychotic Medications for Individuals with Schizophrenia.
• APM – (C, MCD) – Metabolic Monitoring for Children and Adolescents on Antipsychotics.

UTILIZATION

• FPC – (MCD) – Frequency of Ongoing Prenatal Care.
• W15 – (C, MCD) – Well-Child Visits in the First 15 months of Life.
• W34 – (C, MCD) – Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life.
• AWC – (C, MCD) – Adolescents Well-Care Visits.
• FSP – (C, MCD, MCR) – Frequency of Selected Procedures.
• AMB – (C, MCD, MCR) – Ambulatory Care.
• IPU – (C, MCD, MCR) – Inpatient Utilization – General Hospital/Acute Care.
• IAD – (C, MCD, MCR) – Identification of Alcohol and Other Drug Services.
• MPT – (C, MCD, MCR) – Mental Health Utilization.
• ABX – (C, MCD, MCR) – Antibiotic Utilization.
• HAI – (C, MCD, MCR) – Standardized Healthcare-Associated Infection Ratio.

MEASURES COLLECTED THROUGH THE MEDICARE HEALTH OUTCOMES SURVEY

• HOS – (MCR) - Medicare Health Outcomes Survey
• FRM – (MCR) - Fall Risk Management
• MUI – (MCR) - Management of Urinary Incontinence in Older Adults
• OTO – (MCR) - Osteoporosis Testing in Older Women
• PAO – (MCR) - Physical Activity in Older Adults

MEASURES COLLECTED THROUGH THE CAHPS HEALTH PLAN SURVEY

• FVA – (C, MCD) - Flu Vaccinations for Adults 18 – 64
• FVO – (MCR) - Flu Vaccinations for Adults Ages 65 and Older
• MSC – (?) - Medical Assistance with Smoking and Tobacco Use Cessation
• PNU – (MCR) - Pneumococcal Vaccination Status for Older Adults

RISK ADJUSTMENT UTILIZATION

• PCR – (C, MCD, MCR) - Plan All-Cause Readmissions
• IHU – (C, MCR) - Inpatient Hospital Utilization
• EDU – (C, MCR) - Emergency Department Utilization
• HPC – (MCR) – Hospitalization for Potentially Preventable Complications

HEALTH PLAN DESCRIPTIVE INFORMATION

• BCR – (C, MCD, MCR) – Board Certification
• ENP – (C, MCD, MCR) - Enrollment by Product Line
• EBS – (C, MCD, MCR) – Enrollment by State
• LDM – (C, MCD, MCR) – Language Diversity of Membership
• RDM – (C, MCD, MCR) - Race/Ethnicity of Membership
• TLM – (C, MCD, MCR) – Total Membership

MEASURES COLLECTED USING ELECTRONIC CLINICAL DATA SYSTEMS

• ** NEW - DFS – (C, MCD, MCR) – Depression Screening and Follow-Up for Adolescent and Adults.
• DMS – (C, MCD, MCR) – Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults.
• DRR - (C, MCD, MCR) – Depression Remission or Response for Adolescents and Adults.
• ** NEW – ASF – (C, MCD, MCR) – Unhealthy Alcohol Use Screening and Follow-Up.
• PVC – (C, MCR) – Pneumococcal Vaccination Coverage for Older Adults.

Time to start my annual series about the measures so everyone can get ready to tackle HEDIS 2018.

About The Author

Jane Jackson has more than  25 years experience in healthcare, including hospital-based care, home health, and managed care. She enjoys sharing her knowledge and can she be reached at Jane.Jackson@DailyDoseHQ.com. Also visit her blog, Daily Dose HQ.