NCQA HEDIS® MY 2021 and IHA AMP MY 2021 Transition Year – Users Have More Time to Design Intervention Strategies and to Take Action

Interpreta recently completed certification for HEDIS MY 2021 and IHA AMP MY 2021 including certification of survey measures. In doing so, Interpreta has updated our overall process for receiving, reviewing, architecting, and releasing new measures and revised measures for annual certification. We’re encouraged by the additional time to increase analytics impact with our partners across the health plan and provider healthcare landscape.

It’s been a busy year adapting to change and Interpreta would like to discuss our experience to benefit the NCQA analytics community. In the future, we expect the NCQA certification timeline to finish MY 2022 HEDIS certification by June 2022 and IHA AMP certification by August 2022. There will be an exception with the survey measures, which are expected to start certification again next year around October with released specifications and test decks from NCQA.

There are very limited changes in MY 2021 measures compared with MY 2020. Three measures are retired from HEDIS: Disease-Modifying Anti-Rheumatic Drug Therapy for Rheumatoid Arthritis (ART), Enrollment by State (EBS), and Total Membership (TLM).

Several measure stratifications were removed: Childhood immunization combo 2, 3, 4, 5, 6, 8, 9; Enrollment by Product Line (ENP) gender stratification, and Plan All-Cause Readmissions (PCR) 18-64 Medicare SNF reporting. Related changes but outside NCQA certification of CMS QRS measures: Hepatitis A, Rotavirus, Influenza, and Combination 10 are added to childhood immunization; HbA1c Poor Control (>9.0%) indicator is added to the Comprehensive Diabetes Care (CDC) measure and 30-Day Follow-up indicator to the Follow-up After Hospitalization for Mental Illness (FUH) measure.

With technical specifications released much earlier and certifications finished much earlier, HEDIS users have more time to review changes and to design their intervention strategies. This is a change that benefits the industry as a whole, primarily recipients of care. Quality professionals and patient care strategists will have more time to focus on the guidance that analytics tools are providing.