Questions Answered: Electronic Clinical Data for HEDIS Reporting

Today, questions answered.

During the February 24th Future of HEDIS webinar hosted by NCQA, Senior Research Associate Fern McCree presented new ideas for increasing the use and standardization of electronic clinical data for HEDIS® reporting. It was an engaging discussion, and this topic was also the focus of a month-long HEDIS Public Comment which concluded in March.

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We have recently received many excellent questions and feedback about the proposed changes that have helped inform our efforts.  While we could not respond to every comment, below, we have compiled answers to many of your questions, some of which are from the Future of HEDIS webinar and Public Comment. Thank you for participating, providing your feedback, and allowing us to answer your questions.

Stay tuned for updates on NCQA’s efforts to leverage electronic clinical data in HEDIS reporting at upcoming Future of HEDIS webinars.

Questions Answered:  Popular Inquiries


Q. Why did NCQA develop the ECDS reporting standard for HEDIS?

A. The HEDIS ECDS Reporting Standard encourages health information exchange, which is the secure sharing of patient medical information electronically. ECDS reporting is part of NCQA’s larger strategy to enable a Digital Quality System and is aligned with the industry’s move to digital measures.

Q: How does administrative reporting relate to ECDS reporting?

A: Administrative claims are considered a key data source for ECDS reporting if the data can also be made available to a member’s care team. It is one of the four major data categories for ECDS reporting. The ECDS reporting method expands the types of data permitted for HEDIS® reporting by allowing the use of structured data from electronic health records, health information exchanges and clinical registries, and case management systems in addition to administrative claims.

Q: Is NCQA going to phase out the hybrid method of data collection from HEDIS?

A: NCQA is actively assessing the appropriateness of removing the hybrid reporting method from select HEDIS measures as other data sources improve.

Q: When will measures reported using ECDS be included in programs with available benchmarks?

A: NCQA works with our advisory panels and other stakeholders to continuously assess when measures are ready for public reporting and for use in our evaluation programs, such as Health Plan Ratings. In 2021, the Prenatal Immunization Status measure will be publicly reported for the first time (for measurement year 2020). In 2022, NCQA will include the measure in Health Plan Ratings for Medicaid and commercial plans (for measurement year 2021).

Q: Does the move to digital measures impact requirements for the HEDIS Measure Certification program?

A: All HEDIS measure logic, including logic provided in a digital format, must be certified through the NCQA Measure Certification program (https://www.ncqa.org/programs/data-and-information-technology/hit-and-data-certification/measure-certification/).

Q: When will the proposed changes to ECDS reporting go into effect?

A: NCQA continues to evaluate the proposed strategy and timeline to incorporate electronic clinical data for HEDIS reporting. We plan to provide notification of any changes well in advance of the relevant HEDIS publications.

Q: What can health plans do to prepare for ECDS reporting?

A: NCQA is working on various resources to support adoption and clarify questions related to ECDS reporting and digital quality measures. For example, we recently updated FAQs on the NCQA website and released an issue brief describing strategies to improve reporting, based on interviews with health plans that have begun leveraging electronic clinical data for HEDIS. We will release a toolkit highlighting best practices in leveraging clinical data. Throughout next year we will engage stakeholders through the Digital Measurement Community and host several educational events such as the Quality Innovation Series: Digital Quality, Measurement and Reporting, and the Digital Quality Summit.

Questions Answered: Additional Resources

Many technical questions related to the HEDIS ECDS reporting standard are now addressed in the newly updated ECDS FAQs!

For additional engagement opportunities about digital quality measurement, please join the Digital Measurement Community.