Quality measures help ensure our members receive appropriate care. We created tip sheets to help you satisfy quality measures, including Healthcare Effectiveness Data and Information Set (HEDIS®) measures from the National Committee for Quality Assurance.
Compliance with these measures may reduce the need for you to send medical records later for review.
- Asthma Medication Ratio
- Avoidance of Antibiotic Treatment
- Breast Cancer Screening
- Cervical Cancer Screening
- Child and Adolescent Well-Care Visits
- Childhood Immunization Status
- Colorectal Cancer Screening
- Controlling High Blood Pressure
- Diabetes Quality Measures
- Immunizations for Adolescents
- Medicaid Child and Adolescent
- Prenatal and Postpartum Care
- Use of Imaging Studies for Low Back Pain
- Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
- Well-Child Visits in the First 30 Months of Life
Behavioral Health
- Antidepressant Medication Management
- Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications
- Follow-Up After Emergency Department Visit for Substance Use
- Follow-Up After Emergency Department Visit for Mental Illness
- Follow-up After High-Intensity Care for Substance Use Disorder
- Follow Up After Hospitalization for Mental Illness
- Follow-Up Care for Children Prescribed ADHD Medication
- Initiation and Engagement of Substance Use Disorder Treatment
- Metabolic Monitoring for Children and Adolescents on Antipsychotics
- Pharmacotherapy for Opioid Use Disorder
- Prenatal and Postpartum Depression Screening and Follow-up
- Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics
- Use of Opioids from Multiple Providers
HEDIS is a registered trademark of NCQA. Use of this resource is subject to NCQA’s copyright, found here.
The above material is for informational purposes only and is not intended to be a substitute for the independent medical judgment of a physician. Physicians and other health care providers are encouraged to use their own best medical judgment based upon all available information and the condition of the patient in determining the best course of treatment.