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NCQA Eases Telehealth Restrictions for MY 2020/2021

NCQA Eases Telehealth Restrictions for MY 2020/2021

NCQA’s new 2020/2021 HEDIS Manual includes changes in telehealth restrictions. Synchronous telehealth visits require real-time interactive audio and video such as a live videoconferencing. Asynchronous telehealth is not real-time but still requires two-way interaction such as secure text messaging or email. Any measure specification silent about telehealth include synchronous telehealth.

Summary of the Latest Changes Regarding HEDIS Measures and Telehealth:

  • Weight Assessment and Counseling for Nutrition and Physical Activity for Children / Adolescents (WCC):

    Removed the exclusion of member-reported biometric values – body mass index, height, and weight. Also clarified that services rendered during a telephone visit, e-visit or virtual check-in can meet criteria for the Counseling for Nutrition and Physical Activity indicators

  • Care for Older Adults (COA):

    Clarified that services rendered during a telephone visit, e-visit or virtual check-in can meet criteria for Advanced Care Planning, Functional Status Assessment and Pain Assessment indicators.

  • Controlling High Blood Pressure (CBP):

    Added telephone visits, e-visits and virtual check-ins as appropriate settings for BP reading. Also, now allows BPs taken by any digital device and reported or taken by the member.

  • Comprehensive Diabetes Care (CDC):

    Added telephone visits, e-visits and virtual check-ins as appropriate settings for BP readings. Also, will allow BPs taken by any digital device and reported or taken by the member.

  • Follow-up After Hospitalization for Mental Illness (FUH):

    Added that a telephone visit with a mental health provider can count toward both 7 and 30-day follow-up visits.

  • Transitions of Care (TRC):

    Added e-visits and virtual check-ins can be acceptable setting for the Patient Engagement After Inpatient Discharge portion of this measure.

  • Follow-up After Emergency Department Visit for People with Multiple High-Risk Chronic Conditions (FMC):

    Added e-visits and virtual check-ins to be acceptable setting for follow-up visits.

  • Prenatal and Postpartum Care (PPC):

    Added telephone visits, e-visits and virtual check-ins to the Timeliness of Prenatal Care rate and clarified that services provided via telephone, e-visit or virtual check-in can be eligible for use in reporting both prenatal and postpartum rates.

  • Mental Health Utilization (MPT):

    Added telephone visits, e-visits and virtual check-ins to be acceptable setting for telehealth visits.

Curious how these changes might impact your organization? Contact Vee Technologies today and let us help you increase your HEDIS Quality Measure compliance.

 

Rhonda McElvany, RN, CRC - Quality Programs Director

Silas Goldman - Senior Director of Operations This email address is being protected from spambots. You need JavaScript enabled to view it.