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The National Committee for Quality Assurance is adding metrics to the Healthcare Effective Data and Information Set to track how well insurers address health disparities.
The update adds some race and ethnicity breakdowns, revises gender labels for people who are pregnant and includes social needs screening within 2023 measures for health plans.
The revisions fold equity goals into quality assessments and will help health plans identify disparities among their member populations, according to the group.
The committee tracks healthcare quality performance serves as the accrediting body for more than 1,100 insurers. The organization’s quality analytics tool, HEDIS, collects data from health plans covering approximately 203 million people across the U.S.
Race and ethnicity breakdowns are being added to eight HEDIS measures, including childhood and adult immunizations, asthma, emergency department visits for substance use disorder, opioid prescribing and treatment, well-child visits and breast cancer screening. The group also plans to track insurers’ efforts to screen their members’ needs for food, housing and transportation, and how those needs are filled once identified.
Among other revisions, the group is collecting data on pediatric oral health evaluations and use of topical fluoride; benzodiazepine prescription practices among adults older than 67; and preventing emergency department visits for older adults with hypoglycemia.
In a move to measure gender-affirming care, the accrediting organization is removing a limitation on pregnancy and birthing data that only accounts for female patients. It also retired five measures, including annual dental visits, flu vaccinations and pneumococcal vaccination for older adults.
The new metrics come as the committee rolls out a new health equity accreditation that governmental bodies are considering mandating for Medicaid and Marketplace plans. The program focuses on eliminating health disparities by increasing data collection efforts surrounding race, ethnicity, gender and social determinants of health. It also mandates insurers deploy language services and ensure the diversity of their clinical networks matches that of their patient base.
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