The Changing Health Plan Perspective

The past two years have seen some marked changes surrounding the National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS) and The Centers for Medicare & Medicaid Services (CMS) Star Rating.

In 2022, NCQA HEDIS introduced new and revised measures intended to advance health equity for health plans, as well as added five measures to address pediatric dental care, safety and appropriateness, diabetes care, and social needs screenings and interventions (see NCQA Launches New HEDIS Quality Measures For Health Equity). For Star ratings, CMS has a proposed rule that would include a health equity index for . . .