HEDIS evaluates the quality of care across diverse health plans in the United States. With over 90 percent of health plans embracing HEDIS to measure performance, its influence extends to more than 190 million individuals enrolled in these plans. In this blog, we explore the intersection of HEDIS requirements and at home diagnostics, focusing particularly on at home colorectal cancer screening. This non-invasive screening method, including the FIT test, holds promise in enhancing HEDIS scores by facilitating convenient yet effective screening for colorectal cancer. 

What is HEDIS?

The Healthcare Effectiveness Data and Information Set (HEDIS) serves as a widely adopted tool, utilized by over 90 percent of U.S. health plans, to gauge performance across critical dimensions of care and service. With more than 190 million individuals enrolled in health plans that report quality results using HEDIS, its impact is significant. 

Since 2008, medical providers and practices have also had access to HEDIS for assessment purposes. Its widespread adoption and precise measures enable meaningful comparisons among health plans. To ensure ongoing relevance, the National Committee for Quality Assurance (NCQA) maintains a process for evolving the measurement set annually through its Committee on Performance Measurement.

What is at home colorectal cancer screening?

The FIT test, a non-invasive screening method, detects blood in stool samples from the lower intestines, indicating potential colorectal cancer or gastrointestinal issues. This test, suitable for individuals aged 50 to 74 without symptoms and at average risk for colorectal cancer, involves collecting a small stool sample at home and sending it to a laboratory for analysis. It is a convenient screening option that patients can perform in a non-clinical setting. 

Talk to Ash Wellness about implementing FIT screening programs to improve HEDIS. 

How can at home colorectal cancer screening improve HEDIS scores?

The Colorectal Cancer Screening HEDIS measure evaluates adherence to screening guidelines, which include options such as annual fecal occult blood tests, flexible sigmoidoscopies every five years, colonoscopies every ten years, computed tomography colonographies every five years, and stool DNA tests every three years.

Screening for colorectal cancer among asymptomatic adults aged 50–75 is crucial for detecting polyps before they become malignant or identifying the cancer in its initial phases, significantly improving the effectiveness of treatment. Despite the potential for a 90 percent survival rate over five years with early-stage treatment, more than a third of individuals in this age group fail to undergo recommended screenings. Providers and health plans can use at home FIT tests to screen patients to meet HEDIS requirements for colorectal cancer without asking patients to visit a clinic. 

What other at home diagnostics can improve HEDIS scores?

Home diagnostics can improve HEDIS score requirements related to diabetes, medication adherence, and chlamydia. 

• Chlamydia: Within HEDIS, there exists a measure that evaluates the coverage of chlamydia screening for sexually active young women who receive medical services from commercial or Medicaid managed care organizations. At home diagnostic screening supports remote chlamydia testing to reach more patients and boost HEDIS scores. Despite the expansion of chlamydia screening efforts over the past twenty years, a significant portion of at-risk women remain untested, highlighting both the insufficient awareness among some healthcare providers and the limited resources allocated to support such screenings.
• Diabetes: According to HEDIS guidelines, healthcare providers are encouraged to ensure that medical records include documentation indicating the date of the HbA1c test and its results. HbA1c testing is not limited to traditional medical settings; it can also be performed conveniently at home. Using a dried blood spot card, patients can conduct HbA1c tests remotely. This process typically begins with a physician ordering a self-collection kit, which is then delivered to the patient's home either after a telehealth or in-person office visit or as part of routine medical assessments.
• Medication adherence: Both Medicare Star Ratings and HEDIS scores evaluate patient medication adherence, particularly concerning medications for conditions like cholesterol or hypertension. At home diagnostics through dried blood spot cards can assist patients in completing necessary lab tests promptly to avert interruptions to medication intake and promote overall adherence.

Next steps for at home colorectal cancer screening with Ash Wellness 

Ash Wellness provides comprehensive at home diagnostics programs tailored to hospitals, clinics, accountable care organizations, and consumer or state health plans, which can enhance their HEDIS scores. With a repertoire of over 150 diagnostic tests, including screenings for HbA1 levels, sexually transmitted infections (STIs), colorectal cancer, and allergies, we offer a wide range of diagnostic solutions. Our national network of CLIA/CAP certified labs, provider of record API, white-labeled kitting capabilities, and digital tools let clients initiate new programs swiftly, often within weeks.

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