March 2, 2023
The National Committee for Quality Assurance (NCQA) allows patients to be excluded from select HEDIS® star quality measures due to advanced illness and frailty. They acknowledge that measured services most likely would not benefit patients who are in declining health.
Read the Advanced Illness and Frailty Exclusions Guide for a description of the advanced illness and frailty exclusion criteria and a list of the appropriate codes. Using correct codes will reduce medical record requests for HEDIS data collection purposes.
For more information, contact ProviderClinicalConsulting@Premera.com
Source: http://blog.ncqa.org/improving-care-advanced-illness-frailty/
Healthcare Effectiveness Data Information Set. HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)