HEDIS MY2026 Updates: NCQA Proposed Changes
- Teh National Committee for Quality Assurance (NCQA) has released proposed changes to it's Healthcare Effectiveness Data and Information Set (HEDIS) measures for Measurement Year 2026.
- Among the key changes are three proposed new HEDIS measures designed to improve healthcare quality and address specific health concerns.
- NCQA also proposes revisions to six existing HEDIS measures, including:
NCQA’s Measurement Year 2026 HEDIS updates are here! The National Committee for Quality Assurance (NCQA) proposes significant changes,including new HEDIS measures for timely asthma follow-up,tobacco cessation interventions,and capturing disability data. Existing measures also face revisions, with updates to social needs screening and adult immunization protocols. These shifts aim to improve healthcare quality and align with federal standards. Health plans must prepare for a fully digital HEDIS future by 2030, as NCQA seeks feedback on race and ethnicity stratification updates. News Directory 3 brings you this essential news, focusing on the critical implications of these changes for healthcare providers. Discover what’s next for HEDIS reporting and how these updates will shape the future of healthcare measurement.
NCQA Proposes HEDIS Measure Updates for Measurement Year 2026
Updated June 07, 2025
Teh National Committee for Quality Assurance (NCQA) has released proposed changes to it’s Healthcare Effectiveness Data and Information Set (HEDIS) measures for Measurement Year 2026. These updates, part of NCQA’s push toward complete digital reporting by 2030, include new measures and revisions to existing ones. Health plans have an prospect to provide feedback on these proposed changes.
Among the key changes are three proposed new HEDIS measures designed to improve healthcare quality and address specific health concerns. These changes impact how health plans approach quality measurement and reporting.
New HEDIS Measures
The proposed new measures include:
- Follow-Up After Acute Care Visits for Asthma (AAF-E): This measure assesses follow-up visits within 30 days for asthma patients aged 5–64 after acute care, aiming to improve asthma management. It may replace the Asthma Medication Ratio (AMR) measure.
- Tobacco Use Screening and Cessation Intervention (TSC-E): Focusing on members 12 and older,this measure tracks tobacco use screening and cessation interventions. It is proposed to replace the medical Assistance with Smoking and Tobacco Use Cessation (MSC) measure.
- Disability Description of membership (DDM): This measure aims to improve data collection on disability status for members 15 and older,wich can help identify and address care disparities.
Revisions to existing Measures
NCQA also proposes revisions to six existing HEDIS measures, including:
- social Need screening and Intervention (SNS-E): Changes include adding HCPCS G codes and ICD-10 Z codes, and removing assessments from allowable interventions.
- Adult Immunization Status (AIS-E): A new indicator for COVID-19 immunization status would be added for adults 19 and older.
- Lead Screening in Children (LSC-E): this measure is proposed to transition to Electronic Clinical Data Systems (ECDS)-only reporting.
- Follow-Up After High-Intensity Care for Substance Use Disorder (FUI): Proposed changes include allowing the substance use diagnosis to be in any diagnosis position, adding peer support services, and removing pharmacotherapy events.
- Statin Therapy for Patients with Cardiovascular Disease (SPC) and Statin Therapy for Patients with Diabetes (SPD): Both measures would transition to the ECDS reporting method.
Additionally, NCQA is seeking feedback on aligning HEDIS race and ethnicity stratification with updated federal standards, including changes to reporting categories and terminology.
What’s next
Health plans should review the proposed changes and submit comments via NCQA’s portal. These changes will considerably impact HEDIS reporting and quality measurement in the coming years.