HEDIS thresholds for public reporting

MNCM has established minimum thresholds for public reporting to ensure statistically reliable rates. Only medical groups that meet these thresholds are reported. For the HEDIS administrative measures, a minimum threshold of 30 patients per medical group is required. For the HEDIS hybrid measures, a minimum threshold of 60 patients per medical group is required.

Administrative Method: These HEDIS measures use health plan claims data to identify the patients who are eligible for the measure (denominator) and for the numerator. The HEDIS measures in this report that use the administrative method include:

» Breast Cancer Screening

» Chlamydia Screening

» Diabetes Eye Exam

» Follow-up Care for Children Prescribed ADHD Medication

» Use of Spirometry Testing in the Assessment and Diagnosis of COPD

» Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis

Hybrid Method: These HEDIS measures use health plan claims data to identify the patients who are eligible for the measure. Numerator information comes from health plan claims and medical record review data. Because medical record review data is costly and time-consuming to collect, health plans select a random sample from the eligible patients to identify the measure denominator. For the immunization measures, health plans also use data from the Minnesota Immunization Information Connection (MIIC). The HEDIS measures in this report that use the hybrid method include:

» Cervical Cancer Screening

» Controlling High Blood Pressure

» Childhood Immunization Status (Combo 10)

» Immunizations for Adolescents (Combo 2)

eligible hedis minimum patients public reporting reportable reporting threshold

Creation date: 9/5/2019 3:56 PM Updated: 7/7/2020 4:35 PM

This category is for questions related to HEDIS measures.