Blue Cross and Blue Shield of Texas (BCBSTX) complies with state and national demands for accountability by collecting performance data using the Healthcare Effectiveness Data and Information Set (HEDIS®). HEDIS is the most widely used and nationally accepted effectiveness of care measurement tool available. The results are utilized to ensure that our members are getting the best healthcare possible, so it is important that our Providers understand the HEDIS specifications and guidelines.
We want to simplify the process by including the list below of BCBSTX’s MY2023 Measures and important HEDIS dates.
HEDIS MY2023 BCBSTX Medicaid Measures:
Abbreviation
|
Measure
|
WCC
|
Weight Assessment and Counseling for Nutrition and Physical Activity
|
BPD
|
Blood Pressure Control for Patients with Diabetes
|
EED
|
Eye Exam for Patients with Diabetes
|
HBD
|
Hemoglobin A1c Control for Patients with Diabetes
|
CIS
|
Childhood Immunization Status
|
IMA
|
Immunizations for Adolescents
|
CBP
|
Controlling High Blood Pressure
|
PPC
|
Prenatal and Postpartum Care
|
CCS
|
Cervical Cancer Screening
|
In early February 2024, BCBSTX will contact your office to verify the medical record point of contact and provide you with necessary documents for HEDIS MY2023.
If you have any questions, please contact Victoria Lopez by e-mail. Please do not include Protected Health Information (PHI) in the email.
We greatly appreciate your assistance and the care you provide our members and your patients.
Resources
For Texas Medicaid Provider Quality Improvement, review the following resources ranging from quality measures data to current vaccine schedules:
HEDIS is a registered trademark of NCQA. Use of this resource is subject to NCQA’s copyright, found here. The NCQA HEDIS measure specification has been adjusted pursuant to NCQA’s Rules for Allowable Adjustments of HEDIS. The adjusted measure specification may be used only for quality improvement purposes.
Measurement Year (MY) 2023
The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations, and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.
