HEDIS results are now available

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The Alliance’s Quality Improvement and Population Health team has completed the Healthcare Effectiveness Data Information Set (HEDIS) audit for Measurement Year 2022 (MY2022).

HEDIS reports are now available! To get a copy of your site’s performance, please email [email protected] with the subject line “HEDIS Report.”

Merced County

Merced County showed slight gains in Well-Child Visits and Child and Adolescent Well-Care Visits. However, there is still work to be done in these areas to meet Minimum Performance Level (MPL) targets. Overall, Merced provider rates showed eight performance measures beneath the NCQA MPL, six of which are in Childhood Domain measures.

Monterey and Santa Cruz counties

HEDIS results in Monterey and Santa Cruz counties demonstrated outstanding performance. In fact, all measures held to NCQA’s MPL improved from the year prior. This is a remarkable achievement and deserves great applause. No MPLs were observed, an overall indication that Monterey and Santa Cruz providers are providing sufficient health care services to Alliance members, as recognized by DHCS.

MY2023 HEDIS measures

For a listing of NCQA HEDIS Measures for MY2023, please see below.

# Measure Required of MCP Measure Acronym Measure Steward Measure type Methodology Held to MPL
Behavioral Health Domain Measures
1 Follow-Up After ED Visit for Mental Illness – 30 days FUM NCQA Administrative Yes
2 Follow-Up After ED Visit for Substance Abuse – 30 days FUA NCQA Administrative Yes
Children’s Health Domain Measures
3 Child and Adolescent Well-Care Visits WCV NCQA Administrative Yes
4 Childhood Immunization Status – Combination 10 CIS-10 NCQA Hybrid/Admin Yes
5 Developmental Screening in the First Three Years of Life DEV CMS Administrative Yes
6 Immunizations for Adolescents – Combination 2 IMA-2 NCQA Hybrid/Admin Yes
7 Lead Screening in Children LSC NCQA Hybrid/Admin Yes
8 Topical Fluoride for Children TFL-CH DQA Administrative Yes
9 Well-Child Visits in the First 30 Months of Life – 0 to 15 Months – Six or More Well-Child Visits W30-6+ NCQA Administrative Yes
10 Well-Child Visits in the First 30 Months of Life – 15 to 30 Months – Two or More Well-Child Visits W30-2+ NCQA Administrative Yes
Chronic Disease Management Domain Measures
11 Asthma Medication Ratio AMR NCQA Administrative Yes
12 Controlling High Blood Pressure CBP NCQA Hybrid/Admin Yes
13 Hemoglobin A1c Control for Patients With Diabetes – HbA1c Poor Control (> 9%) HBD NCQA Hybrid/Admin Yes
Reproductive Health Domain Measures
14 Chlamydia Screening in Women CHL NCQA Administrative Yes
15 Prenatal and Postpartum Care: Postpartum Care PPC-Pst NCQA Hybrid/Admin Yes
16 Prenatal and Postpartum Care: Timeliness of Prenatal Care PPC-Pre NCQA Hybrid/Admin Yes
Cancer Prevention Domain Measures
17 Breast Cancer Screening BCS-E NCQA Administrative Yes
18 Cervical Cancer Screening CCS NCQA Hybrid/Admin Yes