HEDIS MY 2022 Volume 2: Technical Specifications for Health Plans
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.
A required resource for anyone involved in collecting, calculating or submitting HEDIS data, HEDIS MY 2022 Volume 2 features the complete technical specifications for each measure. It also includes general guidelines for data collection and reporting, detailed instructions about how to perform the necessary calculations and guidelines for sampling.
HEDIS 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.
Disclaimer: The summary specifications for measures reported using electronic clinical data systems (ECDS) that are included in the Volume 2 publication are for reference purposes only and should not be used for programming or reporting of the measures. The full HEDIS digital measure specifications are only available by purchasing a HEDIS digital measure product.
HEDIS MY 2022 Volume 2 incorporates the following additional content, providing added value to our customers:
- Rules for Allowable Adjustments of HEDIS: Recognizing that HEDIS measures have traditionally been specified for health plan reporting, and that the industry desires to apply the measures to different levels of the health care system to facilitate, for example, population health management and development of quality improvement programs and initiatives, NCQA incorporated the “Rules for Allowable Adjustments of HEDIS,” (the “Rules”) into HEDIS Volume 2 alongside applicable HEDIS measures and specifications. The Rules describe an approach and prescribe guidelines for adjusting NCQA’s HEDIS measure specifications for use with other populations. The Rules were reviewed and approved by NCQA measure experts and provide room for evaluating alternate populations without changing the clinical intent of the measure through removal of continuous enrollment or product-line criteria, for example.
- HEDIS MY 2022 Value Set Directory (VSD) Files: The HEDIS VSDs crosswalk HEDIS measure and specifications to third party medical and billing codes to assist in calculating HEDIS measure results, The HEDIS VSD consists of an Excel file (.xlsx) that is made available with the purchase of HEDIS MY 2022 Volume 2 in print or electronic format. The HEDIS VSD is searchable and sortable. The HEDIS VSD is available in electronic format only; customers who purchase the print version of HEDIS Volume 2 will receive the measures in print and the HEDIS VSD in electronic form. These third-party codes may be protected under federal copyright laws and are included in HEDIS Volume 2 with the permission of the copyright owners. All uses of these third-party codes may require a license from the copyright owner.
IMPORTANT: Permitted Use Notice
The HEDIS measures and specifications contained in HEDIS Volume 2 publication were developed by and are owned by NCQA. Unauthorized internal distribution of the publication and materials therein—beyond the number of users licensed by your organization—is prohibited. Anyone desiring broader internal distribution of HEDIS Volume 2 must purchase additional licensed user permissions via the NCQA Store.
An organization’s licensed users may use the materials solely for an internal non-commercial purpose without obtaining NCQA approval. All other uses, including a commercial use (including but not limited to vendors using or embedding the measures and specifications and/or HEDIS VSD into any product or service to calculate measure results for customers for any purpose) and/or any external reproduction, distribution or publication (including but not limited to federal and state entities using or incorporating the measures into their programs) must be approved by NCQA and are subject to a license at the discretion of NCQA.
Anyone contemplating a commercial use, or external reproduction, distribution or publication of any part of Volume 2, should not purchase HEDIS Volume 2 via the NCQA Store, and must contact the NCQA licensing team to discuss the need for a license. Submit this inquiry by logging into My NCQA, selecting the Ask a Question button, then the Orders button, then the Custom License Requests option.
Organizations that need help determining how their use of NCQA’s HEDIS measure specifications and Value Set Directories fit into NCQA’s licensing and certification requirements should use the HEDIS® Licensing Tool.
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