HEDIS MY 2025: Highlighted updates for providers
Date: 08/28/24
NCQA released updates for HEDIS® MY 2025. Meridian’s Quality Improvement team has highlighted essential changes for providers and will walk through the details at the October quality education webinars for providers.
- Three new measures will launch in HEDIS® MY 2025. Each measure is reported using only the Electronic Clinical Data Systems (ECDS) reporting method.
- Blood Pressure Control for Patients with Hypertension (BPC-E): The percentage of members 18–85 years of age who had a diagnosis of hypertension and whose most recent blood pressure was <140/90 mm Hg during the measurement period. The new BPC-E measure has two key modifications from the Controlling High Blood Pressure (CBP) measure:
- It is now ECDS-only.
- The expanded denominator now includes a pharmacy data method requiring a claims-based diagnosis of hypertension and a dispensed anti-hypertensive medication.
- Documented Assessment After Mammogram (DBM-E): The percentage of episodes for members 40–74 years of age with mammograms documented in the form of a BI-RADS assessment within 14 days of the mammogram.
- Follow-up After Abnormal Mammogram Assessment (FMA-E): The percentage of episodes for members 40–74 years of age with inconclusive or high-risk BI-RADS assessments that received appropriate follow-up within 90 days of the assessment.
- Blood Pressure Control for Patients with Hypertension (BPC-E): The percentage of members 18–85 years of age who had a diagnosis of hypertension and whose most recent blood pressure was <140/90 mm Hg during the measurement period. The new BPC-E measure has two key modifications from the Controlling High Blood Pressure (CBP) measure:
- Three additional measures will transition to ECDS-only reporting in MY 2025:
- Childhood Immunization Status (CIS-E)
- Immunizations for Adolescents (IMA-E)
- Cervical Cancer Screening (CCS-E)
- Telehealth will be removed from Well-Child and Adolescent Well-Care Visits (W30/WCV) in MY 2025. This was a temporary addition during the COVID-19 pandemic.
- Adult Immunization Status (AIS-E) added an indicator assessing Hepatitis B immunization for adults 19-59 years of age.
- The Follow-Up After Emergency Department Visit for Mental Illness (FUM) and Follow-Up After Hospitalization for Mental Illness (FUH) measures no longer require a physician to be the principal provider on a claim for the denominator and numerator events.
Learn more at our September quality webinars
Our two October Quality Education webinars will provide more details about the MY 2025 HEDIS® changes and ECDS-only reporting measures, Risk Adjustment programs, and the year-end quality push.
Thursday, October 17 |
Wednesday, October 23 |