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 |
