Healthcare effectiveness data and information set (HEDIS) tip sheets

In our efforts to support our providers, Blue Shield of California Promise has developed the 2024 Healthcare Effectiveness Data and Information Set (HEDIS®) tip sheets to assist providers and their office and billing staff in successfully maximizing their quality performance scores. 

These tip sheets provide concise information on the National Committee for Quality Assurance (NCQA) HEDIS measures along with resources that will help improve health outcomes.  

We also offer provider offices with tailored HEDIS education through our Medi-Cal Quality Improvement Education. Please email qimedical@blueshieldca.com for more information.

Please note that the HEDIS tip sheets are based on the most recent HEDIS technical specifications and are subject to change based on guidance from the NCQA and the Centers for Medicare and Medicaid Services (CMS).  Please refer to the appropriate agency for additional guidance.  

Asthma medication ration (PDF, 438 KB)

Breast cancer screening mammogram (PDF, 296 KB)

Cervical cancer screening (PDF, 337 KB)

Child and adolescent well child visits, ages 3-21 (PDF, 248 KB)

Chlamydia screening in women (PDF, 206 KB)

Childhood immunizations (PDF, 324 KB)

Controlling high blood pressure (PDF, 325 KB)

Depression remission or response for adolescents (PDF, 410 KB)

Depression screening and follow-up for adolescents (PDF, 657 KB)

Developmental screening first three years of life (PDF, 259 KB)

Follow-up after emergency department visit for mental illness (PDF, 433 KB)

Follow-up after emergency department visit for substance use (PDF, 463 KB)

Glycemic status assessment for patients with diabetes (PDF, 453 KB)

Immunizations for adolescents (PDF, 238 KB)

Lead screening in children (PDF, 210 KB)

Prenatal care – Timeliness (PDF, 397 KB)

Postpartum care (PDF, 308 KB)

Topical fluoride for children (PDF, 247 KB)

Well child visit in the first 30 months of life (PDF, 265 KB)

Health Care Options: (844) 580-7272  {TTY: {800) 430-7077}, Monday through Friday from 8 a.m. — 6 p.m. 

For information on Blue Shield Promise plans for your health care, call the Department of Health Care Services at (800) 430-4263 {TTY: (800) 735-2922}, or visit https://www.healthcareoptions.dhcs.ca.gov/.

Blue Shield of California Promise Health Plan is a managed care organization, wholly owned by Blue Shield of California, offering Medi-Cal Plans.

© 2002-2024. California Physicians’ Service DBA Blue Shield of California Promise Health Plan. All rights reserved.

California Physicians’ Service DBA Blue Shield of California Promise Health Plan is an independent licensee of the Blue Shield Association.

The provider network may change at any time. You will receive notice when necessary.

Blue Shield of California Promise Health Plan complies with applicable state laws and federal civil rights laws, and does not discriminate on the basis of race, color, national origin, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, or disability.

Blue Shield of California Promise Health Plan cumple con las leyes estatales y las leyes federales de derechos civiles vigentes, y no discrimina por motivos de raza, color, país de origen, ascedencial, religión, sexo, estado civil, genero, identidad de genero, orientación sexual, edad ni discapacidad.

Blue Shield of California Promise Health Plan遵循適用的州法律和聯邦公民權利法律，並且不以種族、膚色、原國籍、血統、宗教、性別、婚姻 狀況、性別認同、性取向、年齡或殘障為由而進行歧視。

 

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