HEDIS MY 2021 Volume 3 (epub)

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NCQA PUBLICATION LICENSE AGREEMENT

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Anyone contemplating a use beyond a personal, non-commercial use, including but not limited to a commercial use, internal or external reproduction, distribution or publication of any part of a Product or use of a Product to identify records or calculate HEDIS measure results, must contact the NCQA licensing team by submitting a request through https://my.ncqa.org to discuss the need for a license.
Licensee agrees and understands that any score or numeric result calculated from access and use of the Product does not constitute a preliminary or final score and does not predict achievement of accreditation, certification or recognition, as applicable. Any use of the Product to identify records or calculate HEDIS measure results, for example, requires a custom license and may necessitate certification pursuant to NCQA’s Measure Certification Program. The following activities are expressly prohibited in connection with the use of the Product under this License Agreement:

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For Value Set Directory (VSD) Downloads. HEDIS VSDs contain code values owned by third parties (the “Third Party Code Values”), including CPT® owned by American Medical Association, LOINC® owned by Regenstrief Institute, Inc., SNOMED CT® owned by the International Health Terminology Standards Development Organisation, and Uniform Billing Codes owned by the American Hospital Association. HEDIS VSDs are made separately available, at no cost, in electronic format. These third party medical and billing codes are protected under federal copyright laws. No license to reproduce, distribute or incorporate the HEDIS VSDs into any product is granted to Licensee by virtue of this License Agreement. All uses of these Third-Party Code Values may require a license from the copyright owner. Licensee acknowledges and agrees that it is responsible for obtaining a license directly from the copyright owner of each of the Third-Party Code Values, if required. Licensee agrees to indemnify and hold NCQA harmless from any claims and expenses arising out of Licensee’s use and display of Third-Party Code Values included in the HEDIS VSDs, or any portion thereof.

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HEDIS MEASUREMENT YEAR 2021 VOLUME 3: SPECIFICATIONS FOR SURVEY MEASURES

  View Table of Contents for this Publication

Note: NCQA has updated the naming convention of HEDIS publications to refer to the measurement year (MY) for HEDIS measures. Read more about the HEDIS schedule change here.

This volume contains complete instructions for administering all the survey-based HEDIS Measures, including surveys from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) program. Specifically, it includes the CAHPS Health Plan Survey, 5.0H Adult Version, CAHPS Health Plan Survey 5.0H Child Version, Medical Assistance with Smoking and Tobacco Use Cessation, Flu Vaccinations for Adults Ages 18-64, Flu Vaccinations for Adults Ages 65 and Older, Pneumococcal Vaccination Status for Older Adults, and Aspirin Use and Discussion. Volume 3 also includes technical specifications, background information, protocols necessary for administering the survey instruments and accompanying correspondence.

HEDIS (The Healthcare Effectiveness Data and Information Set) is the gold standard in health care performance measurement, used by more than 90 percent of the nation's health plans and many leading employers and regulators. HEDIS is a set of standardized measures that specifies how organizations collect, audit and report performance information across the most pressing clinical areas, as well as important dimensions of customer satisfaction and patient experience.