More on the HEDIS Supplemental Changes

I think there will be extra angst as the changes are fully implemented over the next year.  First for measures that have multiple year look backs you will need primary source data in those look back years. That may be difficulty especially if records are stored and not accessible easily.  One area that I think will cause additional pain when plans take on new members.  You will need accurate records to prove that members got required tests and screening from the year that they weren't members of the plan.  Now we all have been dealing with EHR's in some shape or form and this may not be as easy as you think.  What about the pneumonia vaccine you got 4 years ago or the double mastectomy 12 years go. How about doctor tests and results? Hopefully you got your portable records with you. Now as the impacts become more apparent I think some of the rules maybe modified as NCQA gets the feedback rolling in. Personally I don't see any major changes allowing anything but primary source validation.  Because there is state and federal money implications with these scores and there appears to be some indications that there was improper reporting going on NCQA was placed in a pretty difficult position. Either ratchet down the rules or face possible litigation from the OIG is probably what occurred. While NCQA was formed from Health Plans trying to put industry standards and its roots are in health plan promotion I don't think they had much choice in these changes.