NCQA performance measures center around healthcare issues affecting consumers, clinicians, and health care systems. When a new area of health concern is identified, NCQA staff along with an independent panel of experts from various healthcare sectors begin to develop and implement the new HEDIS measure.
NCQA released information on three new measures 7/1/2020
- Cardiac Rehabilitation (CRE) - Reported by Commercial plans, Medicaid, and Medicare
The percentage of members 18+ who attended cardiac rehabilitation following a qualifying cardiac event - myocardial infarction, coronary artery bypass grafting, heart and heart/lung transplantation or heart valve repair replacement. Cardiac rehabilitation is a medical program to help patients regain cardiovascular function after a cardiac related event. Participation in CR can decrease recurrent cardiac-related events, reduce mortality by more than 12%, reduce hospitalizations by 20 – 30% and improve quality of life.
- Kidney Health Evaluation for Patients with Diabetes (KED) - Reported by Commercial plans, Medicaid and Medicare
The percentage of members 18 – 85 with Diabetes who received a kidney health evaluation - a Glomerular Filtration Rate (GFR) and a Urine Albumin-Creatinine Ratio (uACR) during the measurement year. Diabetic kidney disease is one of the most common adverse effects of Diabetes - affecting 20 – 40%.
- Osteoporosis Screening in Older Women (OSW) – Reported by Medicare only
The percentage of women 65 – 75 who received osteoporosis screening. Osteoporosis is the most common metabolic bone disease and is characterized by low bone mineral density causing bone fragility and increased risk of fracture. Osteoporosis affects about 25% of women 65 years of age and older. Osteoporosis-related fractures cost the health care system an estimated $19 billion annually.
NCQA has labeled these measures as First-Year Measures. The results of the data received are not publicly reported or included in Star Score calculations. If approved for continuation, beginning in the second year, data collection results may be publicly reported and used in the calculation of the plan’s Star Score.
Active HEDIS measures are evaluated yearly based on a review of data received and for any changes in clinical guidelines. Measures may be updated, changed, or recommended for retirement. As measures are retired, NCQA has a large library of potential replacement measures ready to implement.
Vee Technology can help you navigate NCQA quality performance measures.
Rhonda McElvany, RN, CRC - Quality Programs Director
Tony Kollarmalil, MD - Medical Director
Silas Goldman - Senior Director, US Operations