NCQA timeline paves the way for proactive monitoring


Tuesday, September 1, 2020 | By Amy Salls, Sr. Director, Revenue and Quality Analytics

NCQA timeline paves the way for proactive monitoring

As discussed in our previous blog, the National Committee for Quality Assurance (NCQA) evaluates and adjusts quality measures each year as they continue development of a core set of meaningful measures for harmonization of performance measurement across the healthcare industry. However, this is the first time the organization has considered changing the timing for these measure deadlines.

What is changing?

Beginning this year, NCQA is implementing a HEDIS® timeline that paves the way for more proactive quality monitoring, and in the end, fully vetted results that you can rely on. Historically, the HEDIS Technical Specifications were released in July of the measurement period. From July through December, specification clarifications, technical updates, and final reporting tables were released, with the end result being that certified measures were first made available to health plans in December. With the new timeline, specifications will be released five months prior to the start of the measurement period, and certified measures will be available mid-way through the measurement year; both well ahead of previous timelines. 

The new timeline will be transitioned in, with the expectation that it will be in full effect beginning with Measurement Year (MY) 2022. To support this transition, the Technical Specifications for HEDIS MY2020 and HEDIS MY2021 will both be released in July 2020. I encourage you to download our new "HEDIS® MY2020 timeline: Planning, Milestones, and Deadlines" for a handy desk reference to stay on track with this schedule.[i]  Following are specific timeline changes.

  1. Volumes 1 & 2 Publication Date:
    1. Current timeline (HEDIS MY 2020) = July 1, 2020
    2. Transition year (HEDIS MY 2021 combined with HEDIS MY 2020) =  July 1, 2020
    3. Future timeline (HEDIS MY 2022) = August 1, 2021
  2. Volume 2 Technical Update Publication Date:
    1. Current timeline (HEDIS MY 2020) = October 1, 2020
    2. Transition year (HEDIS MY 2021) = March 31, 2021
    3. Future timeline (HEDIS MY 2022) = March 31, 2022
  3. HEDIS Vendor Certification Deadline:
    1. Current timeline = February 15, 2021
    2. Transition year (HEDIS MY 2021) = October 1, 2021
    3. Future timeline (HEDIS My 2022) = July 1, 2022

How does the change impact health plans?

Every year, new and more complex measures are released to address key quality initiatives. With the new timeline, your health plan will have time to adjust quality measurement programs to align with modified and/or new performance measures as well as shifting data collection priorities. For example, several themes continue to be expanded year over year that need to be incorporated into your strategic plans:

  • Assessing the risk for, and monitoring of, substance abuse and mental health conditions
  • Increased use of supplemental data and electronic clinical data to reduce the burden of manual data collection

In addition, your organization will have the added benefit of being able to evaluate results while there is still time to proactively identify and close gaps. 

SS&C Health will be adjusting our standard release schedule in response to the availability of earlier specifications to ensure that you have earlier access to the data you need to excel.

Evaluating quality is more than a once-a-year event, it is a process that includes delivery of care, measurement and continuous evaluation of results. Allowing time to plan programs, evaluate performance and adjust as needed is critical. Your vendor-partner plays a role in your success. Please reach out any time to discuss how we can help with your HEDIS strategy.

 

References:



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