COVID-Driven Telehealth Surge Triggers Changes to Quality Measures

WASHINGTON, June 5, 2020 /PRNewswire/ -- The Board of Directors of the National Committee for Quality Assurance (NCQA) approved a sweeping set of adjustments to 40 of its widely-used Healthcare Effectiveness Data and Information Set (HEDIS) measures – in support of health plans, clinicians and patients who rely on telehealth services in record numbers as a result of the disruption brought on by the COVID-19 pandemic.

The changes will apply to the measurement of healthcare quality starting this year. They align with recent telehealth guidance from the Centers for Medicare & Medicaid Services and other federal and state regulators.

"You cannot drive quality improvement if your measures don't take into account what has quickly become the fastest-growing modality for providing healthcare services," said NCQA President Margaret E. O'Kane. "The timely approval by our Board of these changes signals that we understand the important role telehealth has played in making care available amid an unprecedented national lockdown and that it will continue to be an important part of the healthcare system going forward."

The 40 HEDIS measures that have new accommodations for telehealth are:

Prevention and Screening

Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents

Breast Cancer Screening

Colorectal Cancer Screening

Care for Older Adults

Respiratory

Use of Spirometry Testing in the Assessment and Diagnosis of COPD

Asthma Medication Ratio

Cardiovascular Conditions

Controlling High Blood Pressure

Persistence of Beta-Blocker Treatment After a Heart Attack

Statin Therapy for Patients with Cardiovascular Disease

NEW MEASURE: Cardiac Rehabilitation

Diabetes

Comprehensive Diabetes Care

NEW MEASURE: Kidney Health Evaluation for Patients with Diabetes

Statin Therapy for Patients with Diabetes

Musculoskeletal Conditions

Disease-Modifying Anti-Rheumatic Drug Therapy for Rheumatoid Arthritis- Scheduled for Retirement

Osteoporosis Management in Women Who Had a Fracture

NEW MEASURE: Osteoporosis Screening in Older Women

Behavioral Health

Antidepressant Medication Management

Follow-up Care for Children Prescribed ADHD Medication

Follow-up After Hospitalization for Mental Illness

Follow-up After Emergency Department Visit for Mental Illness

Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medication

Cardiovascular Monitoring for People with Cardiovascular Disease and Schizophrenia

Diabetes Monitoring for People with Diabetes and Schizophrenia

Adherence to Antipsychotic Medications for Individuals with Schizophrenia

Care Coordination

Transitions of Care

Follow-up After Emergency Department Visit for People with Multiple High-Risk Chronic Conditions

Access/Availability of Care

Prenatal and Postpartum Care

Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics

Utilization

Well-Child Visits in the First 30 Months of Life

Child and Adolescent Well Care Visits

Mental Health Utilization

Risk-Adjusted Utilization

Plan All-Cause Readmissions

Hospitalization Following Discharge from a Skilled Nursing Facility

Acute Hospital Utilization

Emergency Department Utilization

Hospitalization for Potentially Preventable Complications

Measures Reported Using Electronic Clinical Data Systems

Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults

Depression Screening and Follow-up for Adolescents and Adults

Postpartum Depression Screening and Follow-up

Prenatal Depression Screening and Follow-up

Breast Cancer Screening

Colorectal Cancer Screening

Follow-up Care for Children Prescribed ADHD Medication

Updates to these 40 measures will be reflected in HEDIS Volume 2 Technical Specifications, to be published on July 1, 2020. Telehealth revisions will be outlined in each measure specification's "Summary of Changes" section.

Changes to all NCQA programs resulting from the pandemic are summarized at https://www.ncqa.org/covid.

NCQA will continue to evolve HEDIS and other products to reflect and reinforce new technology.

FOR MORE INFORMATION:

Andy Reynolds 202-955-3518
reynolds@ncqa.org              

Matt Brock 202-955-1739
brock@ncqa.org        

About NCQA

NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA's Healthcare Effectiveness Data and Information Set (HEDIS^®) is the most widely used performance measurement tool in health care. NCQA's website (ncqa.org) contains information to help consumers, employers and others make more-informed health care choices. NCQA can be found online at ncqa.org, on Twitter @ncqa, on Facebook at facebook.com/NCQA.org and on LinkedIn at linkedin.com/company/ncqa.

Related Files

NCQA Telehealth:COVID-19.docx

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SOURCE National Committee for Quality Assurance (NCQA)