Hospital and Physician Update

September – October 2019

Star and HEDIS tip sheets: Useful tools for improving health care quality

We’ve updated our HEDIS^® tip sheets* for 2019 and posted them on the Clinical Quality Corner page of web-DENIS, along with a series of 15 Star Measure Tips. The tip sheets were developed to assist health care providers and their staff in their efforts to improve overall health care quality and prevent or control diseases and chronic conditions.

The Star Measure Tips highlight select measures related to the Centers for Medicare & Medicaid Services’ five-star quality rating system. Most of the Star measures are also HEDIS measures. HEDIS is one of the most widely used performance improvement tools in the U.S.

Note: When clicking on any of the links in this article, you’ll be prompted to enter your user name and password to access web-DENIS.

HEDIS tip sheets

• Adolescent Well-Care Visits (AWC)
• Antidepressant Medication Management (AMM)
• Appropriate Testing for Children with Pharyngitis (CWP)
• Appropriate Treatment for Children with Upper Respiratory Infection (URI)
• Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis (AAB)
• Cervical Cancer Screening (CCS)
• Childhood Immunization Status (CIS)
• Chlamydia Screening in Women (CHL)
• Comprehensive Diabetes Care - Retinal Eye Exam (CDC-E)
• Flu Vaccinations for Adults Ages 18-64 (FVA)
• Follow-up After Hospitalization for Mental Illness (FUH)
• Follow-up Care for Children Prescribed ADHD Medication (ADD)
• Immunizations for Adolescents (IMA)
• Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET)
• Medical Assistance with Smoking and Tobacco Use Cessation (MSC)
• Medication Management for People with Asthma (MMA)
• Persistence of Beta-blocker Treatment After a Heart Attack (PBH)
• Pharmacotherapy Management of COPD Exacerbation (PCE)
• Postpartum Care (PPC)
• Transitions of Care (TRC)
• Prenatal Care (PPC)
• Use of Imaging Studies for Low Back Pain (LBP)
• Use of Spirometry Testing in the Assessment and Diagnosis of COPD (SPR)
• Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (WCC)
• Well-child Visits in the Third, Fourth, Fifth and Sixth Years of Life (W34)
• Well-child Visits in the First 15 months of Life (W15)

Star measure tip sheets

• Adult Body Mass Index Assessment (ABA)
• Breast Cancer Screening (BCS)
• Colorectal Cancer Screening (COL)
• Comprehensive Diabetes Care (CDC)
• Consumer Assessment of Healthcare Providers and Systems (CAHPS^®) Survey
• Controlling High Blood Pressure (CBP)
• CPT^® II and ICD-10 Codes for Star Measures
• Disease-Modifying Anti-Rheumatic Drug Therapy for Rheumatoid Arthritis (ART)
• Medicare Health Outcomes Survey (HOS)
• Medication Adherence
• Medication Reconciliation Post-Discharge (MRP)
• Osteoporosis Management in Women Who Had a Fracture (OMW)
• Plan All-Cause Readmissions (PCR)
• Statin Therapy for Patients with Cardiovascular Disease (SPC)
• Statin Use in Persons with Diabetes (SUPD)

These tips sheets are housed on the Clinical Quality Corner page of web-DENIS. You can get there by following these steps:

• From the homepage of web-DENIS, click on BCBSM Provider Publications and Resources in the left column.
• Click on Newsletters & Resources.
• Click on Clinical Quality Corner on the left-hand side of the page under Other Resources.

*HEDIS^®, which stands for Healthcare Effectiveness Data and Information Set, is a registered trademark of the National Committee for Quality Assurance, or NCQA.

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Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.