New Healthcare Effectiveness Data and Information Set (HEDIS) Tip Sheets

This applies to both Commercial and Medicaid Expansion Plans

Blue Cross Blue Shield of North Dakota (BCBSND) is pleased to inform our provider community that we have recently added new HEDIS Tip Sheet to our provider website. HEDIS is a National Committee for Quality Assurance (NCQA) tool used by more than 90% of America’s health plans to measure performance on important dimensions of care and service.

HEDIS measures are closely monitored, and the data collected is used to evaluate the quality of care provided to members. These measures track the actual care received, not just what was ordered.

HEDIS tip sheets have been developed to provide an overview of the specifications and criteria for the HEDIS measures. These tip sheets should be used as guides and do not include all measure specification details, exclusions, enrollment criteria, or codes. Final measure rates are based on the complete HEDIS technical specifications for the measure.

New tip sheets:

• Adult Preventative Visits (APV)
• Asthma Medication Ratio (AMR)
• Chlamydia Screening in Women (CHL)
• Emergency Department Visits per 1000
• Eye Exams for Patients with Diabetes (EED)
• Proportion of Days Covered (PDC)
• Use of Imaging Studies for Patients with Low Back Pain (LBP)

To view all our tip sheets, visit the following link: HEDIS Tip Sheet Search | BCBSND.

Questions?
Email bluealliance@bcbsnd.com.