Healthcare Business News

NCQA seeks comments on cancer screenings, use of antipsychotics and other topics

By Sabriya Rice
Posted: February 19, 2014 - 5:00 pm ET

The National Committee for Quality Assurance is seeking public comment on several new and revised measures to be included in the next version of their Healthcare Effectiveness Data and Information Set (HEDIS), a widely used tool to measure healthcare performance. The tool is updated as needed to support the latest scientific evidence about what works in healthcare.

This year, two new measures address the potential overuse of prostate and colorectal cancer screenings. Among the new science being taken into consideration are the U.S. Preventive Services Task Force recommendations against PSA-based screening for prostate cancer, which suggest the risks might outweigh the benefits, as well as the USPSTF recommendations against screening for colorectal cancer in adults over age 85 who are not at high risk. The NCQA also notes the American Urological Association recommendations against routine PSA-based screenings in men 70 years and older who are not at high risk.

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Also included is a suite of new measures focused on the use of antipsychotics in children and adolescents, which the committee says are among the most expensive, highest-risk and fastest-growing medication classes for children with mental disorders. Last year, government health officials raised concerns over use of these medications in pediatric patients, noting that more than three-fourths of young people on Medicaid are taking at least one for an indication that was not FDA-approved. The committee will address six significant concerns, including the use of higher than recommended doses, multiple and concurrent use of the medications, and metabolic screenings and monitoring of children on the drugs.

Finally, the NCQA is considering proposed revisions to seven existing measures, including redefining 30-day readmissions to reflect multiple returns to the hospital within 30 days after a patient is discharged.

“An important part of developing and updating HEDIS is the opportunity for the public to review measures and offer support, recommend changes or ask for clarification,” the NCQA said in their announcement.

Health plans, purchasers, consumers and other stakeholders can visit to read and comment on the relevance, scientific soundness and feasibility of the new measures and proposed changes. The comment period runs through 5 p.m. EST on March 19. New and updated HEDIS measures are expected to be published this summer.

Follow Sabriya Rice on Twitter: @MHSRice

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