As telehealth becomes the new normal, NCQA updates quality measures

The National Committee for Quality Assurance has given the OK for what it’s calling a “sweeping set of adjustments” to 40 of the measures used for HEDIS scores, given the new realities of widespread and scaled-up telehealth use.

WHY IT MATTERS
The Healthcare Effectiveness Data and Information Set measures, widely used in quality-improvement efforts, have been updated by NCQA as more health plans, clinicians and patients embrace telehealth services in a major way during the coronavirus pandemic.

These new changes will apply to healthcare-quality measurement beginning this year, according to NCQA, and align with recent telehealth guidance from the Centers for Medicare & Medicaid Services and other federal and state regulators.

THE LARGER TREND
NCQA notes that updates to the following 40 measures will be reflected in HEDIS Volume 2 Technical Specifications, set to be published on July 1, with telehealth-specific revisions outlined in each measure spec’s “Summary of Changes” section:

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

ON THE RECORD
“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, in a statement. “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.”

Twitter: @MikeMiliardHITN
Email the writer: [email protected]
Healthcare IT News is a publication of HIMSS Media

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