HEDIS® Measurement Year 2027 Updates

Follow-Up After Positive Colorectal Cancer Non-Invasive Screening Test (COF-E)

Measures follow-up colonoscopies after a positive stool-based screening test for patients ages 45–75.

Track positive results and schedule follow-up colonoscopies within 180 days of a positive stool-based screening test.

Prenatal Syphilis Screening (PSY-E)

Measures syphilis screening during pregnancy:

• During the first trimester, OR
• Within 14 days of the first pregnancy diagnosis or prenatal visit, OR
• Within 30 days of enrollment in the health plan/organization

Screen for syphilis early in pregnancy and send screening information through claims or electronic data.

Continuous Glucose Monitoring Utilization for Patients With Diabetes (CGD-E)

Measures continuous glucose monitor (CGM) use among patients ages 18–75 with diabetes on insulin.

Incorporate CGMs into standard insulin-dependent diabetic care.

Pharmacotherapy Management of COPD Exacerbation (PCE)

• Reports 1 rate per patient instead of 2 rates per flare-up.
• Counts flare-ups from inpatient, observation, ED, urgent care and outpatient visits.
• Requires a short-acting rescue inhaler plus long-acting maintenance therapy.
• Excludes patients with asthma.

Ensure patients with COPD have prescriptions for both rescue and long-acting maintenance inhalers.

Glycemic Status Assessment for Patients With Diabetes (GSD-E)

Electronic Clinical Data Systems (ECDS) reporting added. The hybrid GSD measure is still reported for MY 2027.

Submit HbA1c and glucose management indicator results electronically, for example through electronic medical record (EMR) extracts and data feeds to health plans.

Adult Immunization Status (AIS-E)

Pneumococcal vaccine indicator now includes adults 50 and older (previously 65 and older).

Review pneumococcal vaccine status for patients ages 50–64.

Follow-Up After Hospitalization for Mental Illness (FUH)

Follow-up visits no longer need to be with a mental health provider.

Schedule follow-up within 7 and 30 days of discharge with any qualifying provider.

Follow-Up After Acute and Urgent Care Visits for Asthma (AAF-E)

Urgent care visits billed on facility claims now count toward the measure. Readmission logic was also revised.

Schedule follow-up after ED and urgent care visits for asthma, including facility-billed urgent care.

Documented Assessment After Mammogram (DBM-E)

Use of Opioids at High Dosage (HDO)

Risk of Continued Opioid Use (COU)

Approved for retirement.

None needed at this time.