HEDIS® Updates Hangout: We’ve Got the Video (It’s not YouTube)

If you missed the HEDIS® updates Webinar Wednesday, we think you missed an engaging and informative conversation about this year’s updates and their technical specifications. You missed the background on why the decisions were made to add measures and change others. We also discussed the administrative challenges of HEDIS updates and what we can expect in the future. Even more, there was a preview of the updates to Health Plan Accreditation Standards and Guidelines due out in full next week.

HEDIS Updates Hangout: YouTube and Your Firewall

We are aware that some of you tried to tune in but couldn’t break through your office firewall that blocks some video streaming services. We apologize. We are working on ways to simulcast all our video presentations. We know they are no good to you, if you can’t reach them. So, in future presentations, look for more options for viewing. For this one, we’ve posted the video here so you can catch up.

Still not making it through your firewall? Here’s an alternative.

In addition, here are the slides from the presentation:


QnA: The Hangout is Not Over

So, you likely have questions. We ask that you submit them in the comments section below and we’ll get answers. Already, the questions submitted during the live hangout are being circulated among our HEDIS and Accreditation experts. We’ll post answers right here in the blog in the coming days. Make sure you bookmark the blog.


3 thoughts on “HEDIS® Updates Hangout: We’ve Got the Video (It’s not YouTube)

  1. Good Morning Matt,
    In watching this podcast I was very excited to see the I-SNP Exclusion. I have 3 questions about this.
    1) Will this exclusion be dependent on CMS acknowledging the pt’s living in a long-term or institutional setting (like the Hospice exclusion)?
    2) Will this exclusion also apply to pt’s that are incarcerated?
    3) If CMS has to acknowledge the pt’s living situation, what documentation would be acceptable proof of incarceration.
    Thank you so much!

    1. Thank you for your questions Valorie!

      Q1) There are two ways to exclude members age 65 and older as of January 1 of the measurement year from Medicare reporting:
      (1) Enrolled in an Institutional SNP (I-SNP) any time during the measurement year.
      (2) Living long-term in an institution any time during the measurement year as identified by the LTI flag in the Medicare Part C monthly membership file.

      The I-SNP exclusion requires the use of the LTI flag from the Medicare Part C Monthly membership file to identify members living long-term in an institution (long-term institutional care may be a benefit classification for Medicare members). NCQA was informed by CMS that all Medicare plans receive this file monthly and have access to this flag. This means that organizations need to determine how to locate the flag from the file they receive monthly to apply this exclusion.

      Q2) The I-SNP exclusion does not exclude members who are incarcerated. HEDIS measure specifications do not permit incarcerated members to be excluded. We estimate the incidence of incarcerated patients to be low and equal across health plans, thereby not resulting in any material bias when comparing performance across plans.

      Q3) See the response to question 2 above.

  2. Question: If the doctor states-Reason for visit is ED or post hospital follow up and states that what was covered was: med review, physical etc-would this qualify as MRP? Some doctor computer systems read like this. Sometimes it says info is in another computer option and sometimes not.

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