HEDIS 2022: Summary of Changes from NCQA

Please note, this communication applies to Healthy Blue + Medicare℠ (HMO D-SNP) offered by Blue Cross and Blue Shield of North Carolina.

The National Committee for Quality Assurance (NCQA) has changed, revised, and retired HEDIS® for measurement year 2022. Below is a summary of the key changes to be aware of.

Diabetes measures

• NCQA has separated the Comprehensive Diabetes indicators into stand-alone measures:
• Hemoglobin A1c Control for Patients with Diabetes (HBD) (HbA1c Control < 8 and Poor
• Control HbA1c)
• Eye Exam Performed for Patients with Diabetes (EED)
• Blood Pressure for Patients with Diabetes (BPD)
• Kidney Health Evaluation for Patients with Diabetes (KED)

The process measure Comprehensive Diabetes HbA1c testing was retired as the goal is to move towards more outcome measures.

Race/ethnicity stratification

To address healthcare disparities, the first step is reporting and measuring performance. Given this, NCQA has added race and ethnicity stratifications to the following HEDIS measures:

• Colorectal Cancer Screening (COL)
• Controlling High Blood Pressure (CBP)
• Hemoglobin A1c Control for patients with Diabetes (HBD)
• Prenatal and Post-Partum Care (PPC)
• Child and Adolescent Well Care Visits (WCV)

NCQA plans to expand the race and ethnicity stratifications to additional HEDIS measures over several years to help reduce disparities in care among patient populations. This effort builds on NCQA’s existing work dedicated to the advancing health equity in data and quality management.

New measures

Antibiotic Utilization for Respiratory Conditions (AXR): The percentage of episodes for members 3 months of age and older with a diagnosis of a respiratory condition that resulted in an antibiotic dispensing event.

This measure was added given antibiotics prescribed for acute respiratory conditions are a large driver of antibiotic overuse. Tracking antibiotic prescribing for all acute respiratory conditions will provide context about overall antibiotic. Given this new measure, the Antibiotic Utilization measure has been retired.

Deprescribing of Benzodiazepines in Older Adults (DBO): The percentage of Medicare members 65 years of age and older who were dispensed benzodiazepines and achieved a 20% decrease or greater in benzodiazepine dose during the measurement year.

Guidelines recommend that benzodiazepines be avoided in older adults, and deprescribing benzodiazepines slowly and safely, rather than stopping use immediately. There is an opportunity to promote harm reduction by assessing progress in appropriately reducing benzodiazepine use in the older adult population.

Advanced Care Planning (ACP): The percentage of adults 65 to 80 years of age, with advanced illness, an indication of frailty or who are receiving palliative care, and adults 81 years of age and older, who had advance care planning during the measurement year.

Advance care planning is associated with improved quality of life, this measure will allow an understanding if it is provided to those who are most likely to benefit from it. Given this new measure, the Care for Older Adults measure has been retired.

Measure changes

Use of Imaging Studies for Low Back Pain (LBP): This measure was expanded to the Medicare line-of-business and the upper age limit for this measure was expanded to age 75. Additional exclusions to the measure were also added.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

Read a complete summary of 2022 HEDIS changes for more information.

Source: NCQA.org

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