We recently made policy changes and clarifications to the 2025 HEDIS Provider Reference Guide in alignment with the National Committee for Quality Assurance (NCQA) HEDIS MY (Measure Year) 2025 Volume 2 Technical Update.
The following measures were updated:
- Asthma Medication Ratio (AMR)o Removed albuterol-budesonide as an asthma reliever medicationo Revised the Asthma Controller Medications table
- Controlling High Blood Pressure (CBP)o Updated the required exclusions
- Statin Therapy for Patients with Cardiovascular Disease (SPC)o Updated prescription information in the High and Moderate Intensity Statin Medications table
- Eye Exam for Patients with Diabetes (EED)o Updated required exclusions and numerator
- Statin Therapy for Patients with Diabetes (SPD)o Updated prescription information in the High and Moderate Intensity Statin Medications table
- Transitions of Care (TRC)o Revised the hybrid specification for the Notification of Inpatient Admission and Receipt of Discharge Information indicators
- Breast Cancer Screening (BSC-E)o Updated the member age range for this measure from 50-74 years of age to 40-74 years of age
- Blood Pressure Control for Patients with Hypertension (BPC-E)o Updated exclusions and numerator compliance
- Adult Immunization Status (AIS-E)o Updated the numerator criteria of the herpes zoster vaccine
- Social Need Screening and Intervention (SNS-E)o Updated the definitions for the following: Housing instability, Homelessness and Housing inadequacy
Access the guide on the Quality Improvement page through our Provider Incentives webpage in prism (login required).