The National Committee for Quality Assurance (NCQA) is leading a significant shift in healthcare quality measurement, transitioning from traditional HEDIS hybrid measures to Electronic Clinical Data Systems (ECDS) reporting. This transition, phasing in between 2024 and 2029, represents a pivotal moment for health plans, as they must adapt to digital reporting requirements and ensure data accuracy.
As a leader in digital health solutions, Healthmine is committed to helping health plans navigate this transition smoothly. With expertise in data integration, interoperability and quality improvement, Healthmine provides the tools and support necessary for organizations to thrive in a fully digital quality measurement landscape.
A glance at NCQA’s transition timeline: 2024–2029
NCQA’s timeline for retiring hybrid measures and implementing ECDS-based measures includes:
- 2024: Colorectal Cancer Screening (COL)
- 2025: Eye Exam for Patients with Diabetes (EED)
- 2026: Lead Screening for Children (LSC)
- 2027: Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (WCC)
- 2028: Prenatal and Postpartum Care (PPC), Controlling High Blood Pressure (CBP), Blood Pressure Control for Patients with Diabetes (BPD)
- 2029: Transitions of Care (TRC), Care for Older Adults (COA)
As each measure transitions, hybrid methodology will be phased out in favor of ECDS or digital reporting, removing the need for hybrid chart reviews and improving data accuracy.
Key milestones in digital quality measurement
One of the most critical aspects of the transition is the advancement of interoperability and data standards. The adoption of Fast Healthcare Interoperability Resources (FHIR) will enable real-time data sharing and analysis, allowing health plans to streamline their quality measurement processes by 2025.
Additionally, this transition aligns with the CMS Digital Quality Strategic Roadmap, which outlines a multi-year plan to digitize all quality measures by 2030, focusing on:
- Improving data quality to enhance reliability and standardization
- Advancing technology for real-time performance monitoring
- Optimizing data aggregation to improve population health analytics
- Aligning data, tools, and measures for seamless integration
Challenges in the transition
The goal of digital quality is to ensure that members, providers, and health plans have access to the same data, empowering members with the information they need to make informed decisions about their care while fostering transparency and collaboration. For health plans, shifting from hybrid measures to ECDS introduces new challenges in data accuracy and reporting performance. Healthmine has observed significant challenges with the transition of Colorectal Cancer Screening (COL-E) for HEDIS MY2024. When comparing rates to MY2023 COL hybrid performance there is notable decline in rates. The transition to ECDS reporting requires health plans to implement proactive strategies to mitigate performance disparities and increase supplemental data.
"The transition from hybrid HEDIS measures to ECDS reporting presents both challenges and opportunities for health plans. Healthmine’s technology streamlines data collection, enhances reporting accuracy, and minimizes rating drops, ensuring plans stay ahead of competitors while seamlessly adapting to the new digital measurement landscape. Healthmine's expert advisory services can provide tailored support throughout the implementation process, ensuring a smooth transition as each measure is phased in," — Mallory Mueller, VP Population Health and Equity, Healthmine
How Healthmine helps support the transition
Healthmine’s technology solutions are designed to help health plans adapt to the ECDS framework by providing:
- Digital first outreach: Reach all members faster, more cost-effectively, and with trackable, measurable results.
- Follow up in more targeted ways: Leverage direct mail and phone calls to reinforce engagement and close gaps for hard-to-reach members.
- Self-attestation: Empower members to attest to health action completion and expedite reward redemption and claims adjudication.
- Member scheduling feature: Facilitate easy scheduling for critical preventive and follow-up care.
- Expert Advisory Services: Leverage Healthmine’s consulting expertise to create customized roadmaps for health plans, ensuring a seamless transition to ECDS and achieve high performing results.
- In-app education: Deliver relevant, timely health education based on a member’s unique needs, with incentives to drive engagement.
- Wraparound care approach: Identify and address broader healthcare needs proactively; for instance, an eye exam can signal a need for A1C testing, fostering comprehensive care coordination.
- Data optimization & Analytics: Utilize streamlined HEDIS data collection and real-time analytics to enhance reporting accuracy and performance monitoring.
- Member engagement platforms: Deploy personalized outreach strategies to improve compliance and capture member-reported information.
Partner with Healthmine to facilitate a smooth transition
As the NCQA transitions fully to digital quality measurement, health plans need a strategic, omnichannel partner to navigate the complexities of ECDS implementation. Healthmine’s industry-leading expertise and innovative technology can help organizations optimize their quality reporting and improve member outcomes. To learn more about how Healthmine can support your health plan through this transition, contact us today.
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