Clinical HEDIS Measures Can be SATISFIED by telehealth (incl. audio only) Can be DISCUSSED via telehealth (incl. audio only) Can be SATISFIED with an in-home test Kit Adult Body Mass Index (BMI) Assessment (ABA) No Yes No Breast Cancer Screening (BCS) Yes1 Yes No Care for Older Adults – Medication Review (COA-Med) Yes Yes No Care for Older Adults – Pain Screening (COA-Pain) Yes Yes No Colorectal Cancer Screening (COL) Yes1 Yes Yes Comprehensive Diabetes Care – Blood Sugar Controlled (CDC-A1C) Yes1 Yes Yes2 Comprehensive Diabetes Care – Eye Exam (CDC-Eye) Yes1 Yes No Comprehensive Diabetes Care – Nephropathy (CDC-Neph) Yes3 Yes Yes Controlling Blood Pressure (CBP) Yes4 Yes No Rheumatoid Arthritis Management (ART) No Yes No Medication Reconciliation Post-Discharge (MRP) Yes Yes No Osteoporosis Management in Women who had a Fracture (OMW) No Yes No Plan All-Cause Readmissions (PCR) No Yes No Statin Therapy for Patients with Cardiovascular Disease (SPC) No Yes No
1 Can be satisfied during a telehealth visit when a patient-reported service is documented in a submitted medical record
2 Can be satisfied when a returned hemoglobin A1c (HbA1c) test kit has results of 9% or less
3 Can be satisfied with a telehealth visit only if the telehealth visit is with a nephrologist
4 Can be satisfied with a telehealth visit when the patient is using a remote monitoring device that digitally stores and directly transmits results to the provider for interpretation. Patients can also visually share the results by displaying the device, a screenshot of it, or a printout. Patient reported readings are also now acceptable for this measure.
Patient Safety (Part D) Measures Can be SATISFIED by telehealth (incl. audio only) Can be DISCUSSED via telehealth (incl. audio only) Can be SATISFIED with an in-home test Kit Medication Adherence for Cholesterol (Statins) (MedA-Statin) No Yes† No Medication Adherence for Diabetes Medications (MedA-Diabetes) No Yes† No Medication Adherence for Hypertension (angiotensin-converting enzyme (ACE) or angiotensin-receptor blocker (ARB) (MedA-HTN) No Yes† No Comprehensive Medication Review (CMR) Yes Yes No Statin Use in Persons with Diabetes (SUPD) No Yes† No
† Can only be satisfied by pharmacy claims processed when patients fill prescriptions for applicable medications
Patient Experience (CAHPS/HOS) Can be SATISFIED by telehealth (incl. audio only) Can be DISCUSSED via telehealth (incl. audio only) Can be SATISFIED with an in-home test Kit Access to Care (Did you experience any difficulty scheduling your appointment?) No Yes No Access to Care (Did you have trouble with your prescription drug plan covering any prescriptions drugs you were taking?) No Yes No Coordination of Care (Did your personal doctor talk about all the prescription drugs you were taking?) No Yes No Coordination of Care (Did your personal doctor seem informed and up to date about the care you got from specialists?) No Yes No Patient Discussion (Did your doctor or other healthcare provider talk to you about falling or problems with balancing or walking?) No Yes No Patient Discussion (Did your doctor or other healthcare provider suggest any healthcare treatment, such as using a cane or walker, having your blood pressure checked, or having regular vision or hearing test?) No Yes No Patient Discussion (Have you ever talked with a doctor, nurse, or other healthcare provider about leaking of urine?) No Yes No Patient Discussion (Did your doctor, nurse, or other healthcare provider talk to you about ways to control or manage leakage of urine?) No Yes No Patient Discussion (Did your doctor or other healthcare provider advise you to start, increase, or maintain your level of exercise or physical activity?) No Yes No Patient Discussion (Has your doctor or other healthcare provider talked to you about your mental or emotional health, or things like feelings of stress, depression or anxiety?) No Yes No