NCQA Finalizes HEDIS® Telehealth Framework, Goals and Resources

In Affinite Quality, Covid-19, HEDIS & Quality Management by Marketing

As I noted in a previous blog post, NCQA has acted swiftly to adjust HEDIS® requirements to reflect the treatment and outreach challenges presented by COVID-10. Striving to limit healthcare professionals’ exposure to the virus, the new guidelines for outpatient care through video and telephone calls and readings from in-home monitors. Self-isolation recommendations and many patients’ reluctance to travel for doctors’ appointments and spend time in waiting rooms also have influenced the growth of telemedicine.

The Telehealth Framework

NCQA outlines nine considerations that plans should address to create a holistic approach to member health and overall well being through telemedicine. The goal is to enable the collection of members’ wellness data, collect information regarding their symptoms, answer questions they have about their conditions, and disseminate information about how COVID-19, social determinants, and environmental factors may affect their health.

Foundational objectives

  • Regulatory Compliance
  • Financial Responsibility
  • Privacy/Security/HIPAA
  • Technology and Interoperability

Value-adding services

  • Patient Engagement
  • Data-Supported Standards of Care
  • Robust, Quality Metrics
  • Workforce Expertise
  • Continuity of Care

Telehealth Policy Goals

The taskforce notes that “early evidence on uptake, costs and patient experience during COVID shows telehealth has exceeded expectations, and many hope to retain its benefits once the pandemic ends.”

Efficient collection and sophisticated analysis of electronically collected data transforms information and statistics into actionable insights health plans can use to  guide their care decisions and segment populations. 

Additional Resources

NCQA’s Telehealth Policy Taskforce will release its final report and conduct a webinar on September 15 at 2 p.m. Eastern Time to explain the logic behind its decisions. To be the first to receive Vital Data Technology’s insights on these final changes, fill out the form, and we will send you our analysis of the report and webinar discussion.

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Kelly Cieciorka MPA, HSA
Director of Quality

Kelly is the Director of Quality and Product Owner of Affinitē Quality™. She is responsible for guiding the quality product’s development and partnering with customers for successful implementation and optimization of the solution. Affinitē Quality is Vital Data Technology’s year-round HEDIS® and plan-defined quality management and submission module fully certified by NCQA for 2020 HEDIS measures.

She graduated from the University of San Francisco with a master’s degree in public administration. She has an undergraduate degree in pre-med and biology from the University of California, Santa Barbara.

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