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HEDIS 2022 is Here: Everything Payers Must Know

It’s no secret that competition in the healthcare space is at an all-time high.

And while always top-of-mind, meeting quality metrics is taking the driver’s seat when it comes to organizational priorities.

With the release of the coming year’s HEDIS®1 metrics, payers can identify areas of improvement, as well as existing care gaps.

And given that NCQA Health Plan Ratings and Medicare Stars Ratings both consider HEDIS measure performance in their calculations, these annual additions and revisions offer a path toward proof of value.

In this blog, we’ll explore the three new HEDIS measures and how these additions can enable improved care and adherence.

New HEDIS Measures

With a focus on patient-centered care, HEDIS’ four new measures address safety, medication management, appropriateness, and transitions of care.

Transitions of Care

Focused on care coordination delivered by the member’s primary care provider after an inpatient hospitalization, this measure will be added to the Medicare Star Rating program starting in 2022. This measurement will receive a weight of one in the MA and Overall Star Rating calculation.

The measure represents the percent of discharges for members over 18 presenting the following four rates:

  • Notification of inpatient admission, receipt on the day of admission, or the following day
  • Receipt of discharge information, receipt the day of discharge, or the following day
  • Patient engagement after inpatient discharge, engagement within 30 days of discharge
  • Medication reconciliation post-discharge, complete within 31 days of discharge

Advance Care Planning

This strategic measure can:

  • Improve quality of life
  • Increase provider trust
  • Decrease hospitalization

Advance care planning also enables identification of beneficiaries who are likely to benefit from this preventative process.

Antibiotic Utilization for Respiratory Conditions

This measure takes aim at reducing antibiotic overuse historically associated with respiratory conditions.

By actively tracking antibiotic prescription for acute respiratory conditions, context regarding a plan’s overall antibiotic use and trends will emerge.

Deprescribing Benzodiazepines in Older Adults

The 2019 American Geriatrics Society Beers Criteria recommended benzodiazepines no longer be prescribed for older adults.

This measure affords an opportunity to assess progress reducing benzodiazepines in older adults in appropriate cases.

These three new measures highlight commitment to person-centered care.

Through appropriate assessment, providers can gain insight into areas needing improvement, making appropriate alterations to adhere to new processes and proving value resoundingly.

To learn more about how Collective Medical, a PointClickCare Company, can help you align with new HEDIS measures, click here.

1 HEDIS® is a registered trademark of NCQA.