NCQA has posted its annual summary of changes to the HEDIS measures.

👀 Eye Exam no longer contains the hybrid numerator component. Much like COL, health plans should take the time now to identify providers where eye exams were only found through chart chase and close that data gap.

🏥 FMC They have added a lab claim exclusion to the value set to exclude lab claims from the measure. If for some reason lab claims are contributing to this measure, research should be performed to determine impact. There have also been some additional exclusions added to the measure denominator.

🤕 COA Pain Assessment (SNP Only) has been axed. NCQA is exploring the development of a new chronic pain measure for the future, as of now, no more pain assessment measure.

💉 Blood Pressure Control for Patients with Hypertension (BPC-E) - This measure is the ECDS version of Controlling Blood Pressure. Don’t worry it hasn’t replaced it yet, but health plans have officially been put on notice! Be proactive now and work with providers to submit CPTII codes.

We've already started the work on getting our Stars 2027 environment up and running here at Hyperlift. It will be interesting to see what impact these changes have to our current clients down the road.

Keep Calm and HEDIS On!