HEDIS thresholds for public reporting
Creation date: 9/5/2019 3:56 PM
Updated: 1/13/2026 9:22 AM
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 and ECDS 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/ECDS Method: These HEDIS measures use health plan claims data and potentially other electronic clinical data sources to identify the patients who are eligible for the measure (denominator) and for the numerator. The HEDIS measures that use the this 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
» Cervical Cancer Screening (MY2025 and forward)
» Childhood Immunization Status (Combo 10) (MY2025 and forward)
» Immunizations for Adolescents (Combo 2) (MY2025 and forward)
- 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. The HEDIS measures that use the hybrid method include:
» Cervical Cancer Screening (MY2024 and prior)
» Controlling High Blood Pressure
» Childhood Immunization Status (Combo 10) (MY2024 and prior)
» Immunizations for Adolescents (Combo 2) (MY2024 and prior)