2022 HEDIS quality measure changes

In October 2021, the National Committee for Quality Assurance released value set changes for some HEDIS Healthcare Effectiveness Data and Information Set quality measures.**

Here are new and returning measures that are expected to be included in the Medicare Star Ratings:

• Follow-Up After Emergency Department Visit for People with Multiple High-Risk Chronic Conditions (FMC)
• Patients ages 18 and older who have multiple high-risk chronic conditions and who had a follow-up visit within seven days of an emergency department visit

• Plan All-Cause Readmissions (PCR)
• The number of acute inpatient and observation stays for patients ages 18 and older who were followed by an unplanned acute readmission for any diagnosis within 30 days

• Transitions of Care (TRC)
• Patients who had an acute or non-acute inpatient discharge during the measurement year and who had each of the following:
• Notification of inpatient admission
• Receipt of discharge information
• Patient engagement after inpatient discharge
• Medication reconciliation post-discharge

• The Comprehensive Diabetes Care measures have been separated as follows:
• Eye Exam for Patients with Diabetes (EED)
• Patients ages 18 to 75 with a diagnosis of diabetes (Type 1 or Type 2) who received screening or monitoring for diabetic retinal disease

• Hemoglobin A1c Control for Patients with Diabetes (HBD)
• Patients ages 18 to 75 with a diagnosis of diabetes (Type 1 or Type 2) whose HbA1c was adequately controlled (≤9%) as of Dec. 31 of the measurement year

• Kidney Health Evaluation for Patients with Diabetes (KED)
• Patients ages 18 to 85 with a diagnosis of diabetes (Type 1 or Type 2) who received a kidney health evaluation, defined by an estimated glomerular filtration rate, or eGFR, and a urine albumin-creatinine ratio, or uACR, during the measurement year

Our HEDIS and Star tip sheets are in the process of being updated for 2022. Once they’ve been updated and posted on web-DENIS, we’ll publish a Record article to let you know.

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