HEDIS Measures Established for Disease State Comparison
Among the listed disease states, HEDIS measures have been established for hypertension and heart failure, which can be used to compare the performance of individual institutions based on national benchmarks. 1
Hypertension HEDIS Measures
Hypertension has well-established HEDIS measures that have been tracked for decades:
The HEDIS Hypertension Measure assesses adults 18-85 years of age with diagnosed hypertension whose blood pressure is adequately controlled according to specific criteria 1:
- Adults 18-59 years: BP <140/90 mm Hg
- Adults 60-85 years with diabetes: BP <140/90 mm Hg
- Adults 60-85 years without diabetes: BP <150/90 mm Hg (updated to <140/90 mm Hg in 2018)
These measures have been tracked from 1999-2017 across different healthcare settings including Commercial HMOs, Commercial PPOs, Medicaid HMOs, Medicare HMOs, and Medicare PPOs 1
The National Committee for Quality Assurance (NCQA) uses these measures to assess quality of care and provide national benchmarks for comparison 1
Heart Failure HEDIS Measures
Heart failure also has established HEDIS measures that are used for institutional comparison:
The ACC/AHA Task Force on Performance Measures has developed performance measures for heart failure that are suitable for public reporting and explicit comparisons between institutions 1
These measures focus on key processes of care for heart failure, including the use of angiotensin-converting enzyme inhibitors or angiotensin receptor antagonists for heart failure with left ventricular systolic dysfunction 1
Heart failure measures have been incorporated into HEDIS and are used for quality assessment and comparison between healthcare providers and institutions 1
Peripheral Artery Disease and Chronic Kidney Disease
While peripheral artery disease (PAD) has been mentioned as having performance measures "in development" as of 2008 1, there is no clear evidence in the provided materials that established HEDIS measures for PAD are currently used for national benchmarking
For chronic kidney disease (CKD), the provided evidence does not indicate established HEDIS measures specifically for CKD that are used for national benchmarking
Importance and Impact of HEDIS Measures
HEDIS measures serve as important tools for quality improvement, with evidence showing that improvements in performance on cardiovascular disease measures can prevent significant numbers of adverse outcomes 2
For hypertension specifically, control of blood pressure has been identified as having the largest potential effect on quality at the national level 2
Performance reporting through HEDIS has contributed to meaningful improvements in care, as demonstrated by the increase in post-MI beta-blocker use from 62% in 1996 to 85% in 1999 1
Limitations and Considerations
Some concerns exist about potential overtreatment resulting from strict adherence to HEDIS measures, particularly in elderly patients with diabetes 3
There can be significant variation in adherence to quality indicators among health plans, highlighting the importance of these measures for identifying gaps in care 1
HEDIS measures primarily focus on processes of care rather than outcomes, which may limit their ability to fully capture quality of care 4
By understanding which disease states have established HEDIS measures, healthcare institutions can better focus their quality improvement efforts and prepare for performance comparisons on a national scale.