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Quality Programs: HEDIS & PQA

HEDIS Measures Tip Sheet

Healthcare Effectiveness Data and Information Set (HEDIS)

HEDIS®1 Quality Measures Tip Sheets

Date Published

Applies to:

Florida Blue Commercial

FEP2

Florida Blue Medicare Stars

Florida Blue Medicare

Truli for Health3

Antidepressant Medication Mgmt (AMM) Feb 2024

 

Adults' Access to Primary Care (AAP)

Mar 2024

 

 

 

Alcohol/Drug Abuse/Dependence: Follow Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA)

Mar 2023

 

 

Asthma Medication Ratio (AMR)

Feb 2024

 

 

Asthma: Medication Management for People with Asthma (MMA)

Retired 2020

         

Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB)

Feb 2024

 

 

Back Pain: Use of Imaging Studies for Lower Back Pain (LBP)

Feb 2024

 

 

 

Blood Pressure: Controlling Blood Pressure (CBP)

Feb 2024

Blood Pressure Control for Patients with Diabetes (BPD)

Feb 2024

Breast Cancer Screening (BCS) Feb 2024

Cardiovascular Disease: Statin Use in Patients with Cardiovascular Disease (SPC)

Feb 2024

Care for Older Adults (COA)

Feb 2024

 

 

 

Cervical Cancer Screening (CCS) Feb 2024

 

 

Child and Adolescent Well-Care Visits (WCV) Feb 2024

 

 

 

Children and Adolescents' Access to Primary Care Physician (CAP) Retired 2020          
Chlamydia Screening for Women (CHL) Feb 2024

 

 

 

 

Colorectal Cancer Screening (COL)

Feb 2024

Pharmacotherapy Management of COPD Exacerbation (PCE)

Feb 2024

 

 

 

Eye Exam for Patients with Diabetes (EED)

Feb 2024

✓ 

Follow-Up After Emergency Department Visit for People with Multiple High-Risk Chronic Conditions (FMC)

Mar 2024

 

 

 

Glycemic Status Assessment for Patients with Diabetes (GSD) Feb 2024

Hemoglobin A1c Control for Patients with Diabetes (HBD)

Please refer to the GSD tip sheet above.

Retired 2023          

Immunizations for Adolescents (IMA)

Feb 2024

 

 

 

Immunization: Childhood Immunization Status (CIS)

Feb 2024

 

 

✓*

Kidney Health Evaluation for Adults with Diabetes (KED)

Feb 2024

 

 

Medication Reconciliation Post-Discharge (MRP)

See TRC

         

Mental Illness: Follow-Up After Emergency Department Visit for Mental Illness (FUM)

Mar 2024

 

 

Mental Illness: Follow-Up After Hospitalization (FUH)

Feb 2024

 

 

Follow-Up After High-Intensity Care for Substance Use Disorder (FUI)

Mar 2023

 

 

Initiation and Engagement of Substance Use Disorder Treatment (IET)

Feb 2024

 

 

 

Opioids: Pharmacotherapy for Opioid Use Disorder (POD)

Feb 2024

 

 

Opioids: Use of Opioids From Multiple Providers (UOP)

Feb 2024

 

 

Osteoporosis Management in Women (OMW)

Feb 2024

 

 

 

Persistent Use of Beta Blockers After Heart Attack (PBH)

Mar 2023

 

 

Appropriate Testing for Pharyngitis (CWP) Feb 2024

 

 

 

Plan All-Cause Readmissions (PCR)

Feb 2024

Prenatal and Postpartum Care (PPC)

Feb 2024

 

 

Transitions of Care (TRC)

Feb 2024

 

 

 

Upper Respiratory Infection: Appropriate Treatment for Upper Respiratory Infection (URI) Feb 2024

 

 

Weight Assessment and Counseling in Children (WCC)

Feb 2024

 

 

 

Well-Child Visit (W30)

Feb 2024

 

 

PQA Measures Tip Sheet

Pharmacy Quality Alliance (PQA)

Pharmacy Quality Alliance (PQA) Quality Measures Tip Sheets

Date Published

Applies to:

Florida Blue
Commercial

FEP

Florida Blue
Medicare Stars

Florida Blue
Medicare

Adherence to Antipsychotic Medications for Schizophrenia (SAA) Feb 2024

 

 

 

International Normalized Ratio Monitoring of Those on Warfarin (INR) Feb 2024

 

 

 

Medication Adherence: Cholesterol (Statins PDC-STA)

March 2024

 

 

Medication Adherence: Diabetes (PDC-DR)

March 2024

 

 

Medication Adherence: Hypertension (PDC-RASA)

March 2024

 

 

Monitoring of Individuals on Long-Term Opioid Therapy (AMO) Feb 2024

 

 

 

Statin Use in Persons with Diabetes (SUPD)

March 2024

 

 

1 HEDIS (Healthcare Effective Data and Information Set) is a registered trademark of the National Committee for Quality Assurance (NCQA).

2 Federal Employee Program®

3 Health coverage is offered by Truli for Health, an affiliate of Florida Blue. These companies are Independent Licensees of the Blue Cross and Blue Shield Association.

* Truli for Health will not include influenza in CIS measurement.