HEDIS 2000: New measures spotlight chronic care

Asthma, heart disease, chlamydia among latest adds

The National Committee for Quality Assurance (NCQA) in Washington, DC, recently completed a review of a draft for HEDIS (Health Plan Employer Data and Information Set) 2000, the latest update to the performance measurement tool used by more than 90% of the nation’s health plans. New measures were added to HEDIS 2000 covering heart disease, asthma, chlamydia, and menopause counseling. By design, the new measures will help focus the health care community’s efforts where they can do the most good — on conditions for which effective treatments exist but have been underused.

"HEDIS 2000 will show us how well health plans are caring for some of their sickest members," said NCQA president Margaret E. O’Kane in a statement. The sixth iteration of the standards, HEDIS has evolved from process measures focused on prevention to process and outcome measures on prevention, and acute and chronic care.

The tools will now measure the spectrum of care, from prevention to acute care to management of chronic illness, with the following measures:

    • an outcome measure of the percent of health plan members with diagnosed hypertension whose blood pressure is controlled to 140/90 or better;

    • a process measure of the percent of high-risk asthmatic health plan members receiving anti-inflammatory medications;

    • an outcome measure of the percent of high-risk asthmatics who visit a hospital emergency department;

    • a process measure of the percent of sexually active young women who are screened for chlamydia;

    • a three-part measure of management of menopausal women — whether women receive counseling, the scope of the counseling, and whether the counseling was personalized.

Two other measures regarding cholesterol management after an acute cardiac event and comprehensive care of diabetes will also be fully phased in as part of HEDIS 2000. "Cholesterol Management After an Acute Cardiac Event" assesses whether health plan members suffering heart attacks have had their low-density lipoprotein (LDL) level screened and whether it is under control. This year, plans will report on the screening aspect of the measure, and in 2000 they will also report on the measure’s control aspect. "Comprehensive Diabetes Care" looks at blood sugar testing and control; cholesterol screening and control; eye exams; and monitoring for kidney disease. In 1999, this measure is voluntary; in 2000, it becomes mandatory.

The comment period on the HEDIS 2000 draft has ended, and final HEDIS 2000 technical specifications will be available in June.