Decoding HEDIS® MY 2024 for Success in MY 2025

HEDIS measures are integral to assessing healthcare quality nationwide, influencing clinical practices, payer strategies, and reimbursement models. Updated annually by the National Committee for Quality Assurance (NCQA), these measures evolve to reflect changing clinical guidelines, technological advancements, and health equity priorities. In this guide, we will break down the significant differences between HEDIS 2024 and 2025, provide insights into the new and retired measures, and offer actionable steps for healthcare providers and payers to navigate these updates effectively. Understanding these changes is crucial for maintaining compliance and optimizing healthcare delivery in the coming years.

I. Why HEDIS Updates Deserve Attention

A. The Scale of HEDIS

HEDIS is one of the most widely used tools for evaluating healthcare quality in the United States, and its scale cannot be overstated. Over 90% of U.S. health plans utilize HEDIS metrics to measure and improve the quality of care they provide. This widespread adoption directly affects more than 200 million covered lives, making HEDIS a central pillar in shaping healthcare delivery and payer-provider interactions nationwide.

1. Used by over 90% of the U.S. Health Plans: From major insurers to regional plans, HEDIS measures guide healthcare quality assessments and reporting nationwide.
2. Impacts Over 200 Million Covered Lives: The reach of HEDIS measures is vast, encompassing a substantial portion of the U.S. population, directly affecting millions of patients and their access to quality care.
3. Tied to NCQA Accreditation and CMS Star Ratings: Performance on HEDIS measures is a critical factor in obtaining and maintaining NCQA accreditation and achieving favorable CMS Star Ratings, both of which can influence payer contracts and reimbursement rates.

B. Why Annual Updates Matter

Each year, the NCQA updates HEDIS measures to ensure they remain relevant, reflect the latest clinical research, and align with industry-wide shifts in healthcare practices. These updates have a direct impact on clinical workflows, payer data strategies, and reimbursement mechanisms. Staying current with these changes is not only a matter of compliance but also an opportunity to improve patient care, optimize revenue, and ensure that healthcare delivery remains effective and responsive to patient needs.

1. Impact on Clinical Workflows, Payer Data Strategies, and Reimbursement: Changes to HEDIS measures often require modifications in how healthcare providers document care, track outcomes, and report to payers. Failure to adopt new measures or to keep up with updates could result in missed revenue opportunities or non-compliance penalties.
2. Early Adoption Mitigates Compliance Risks and Revenue Loss: By embracing updates early, providers and payers can avoid costly disruptions. Proactively addressing new measures ensures that workflows remain aligned with NCQA standards, reducing the risk of compliance-related issues.

C. Timelines

The HEDIS reporting timeline is crucial for healthcare providers and payers to understand and prepare for. The NCQA typically releases updated specifications in mid-year, with a reporting year that begins January 1. Submissions for the previous year’s data are due by mid-summer. Understanding these key dates helps organizations plan and execute necessary changes in time for the start of each measurement year.

1. Specifications Released Mid-Year: NCQA typically publishes the specifications for each HEDIS measurement year in mid-year, giving organizations a window to review changes and implement adjustments.
2. Measurement Year Begins January 1: The HEDIS reporting period starts on January 1, with organizations collecting data throughout the year.
3. Submissions Due in Summer: The final step in the HEDIS process involves submitting the data by mid-summer, ensuring all reporting is completed and compliance standards are met.

II. HEDIS MY 2024 in Review

A. New Measures in 2024

Each year, NCQA introduces new measures to reflect the evolving landscape of healthcare and address critical needs. The 2024 update introduced several important additions to HEDIS, further focusing on preventive care, mental health, and chronic disease management.

1. Depression Screening with PHQ-9: The PHQ-9 (Patient Health Questionnaire-9) was added to encourage routine screening for depression, a key mental health issue affecting millions of Americans. This measure supports early identification and management of depression in both adults and adolescents.
2. Statin Therapy Optimization (SPC): Statin therapy for patients with cardiovascular disease (CVD) is now a key focus, with an emphasis on optimizing treatment regimens. The SPC measure aims to ensure that patients at high risk of heart attack and stroke receive appropriate preventive care.
3. Refinements to Childhood Immunizations: Updates to this measure aim to streamline and improve tracking of childhood immunization rates, a critical public health measure that protects young populations from preventable diseases.

B. Retired or Revised Measures

As HEDIS evolves, some older measures are retired or revised to reduce redundancy and streamline reporting. These changes ensure that the metrics remain relevant and continue to reflect the best healthcare practices.

1. Streamlined Osteoporosis (OMW) and Diabetes Measures: The osteoporosis management measure for women (OMW) and certain diabetes care metrics have been simplified. These changes focus on improving the clarity and usability of the measures for healthcare providers.
2. Changes to Cardiovascular Measures: Some cardiovascular measures were revised to better align with the latest clinical guidelines and to improve the effectiveness of heart disease management tracking.

C. Lessons from 2024

The 2024 HEDIS reporting year provided valuable insights into the challenges and opportunities of the evolving healthcare landscape. From hybrid reporting to data completeness issues, providers and payers faced several hurdles that will shape the preparation for the 2025 updates.

1. Hybrid Reporting Persists, but ECDS is Gaining Momentum: Hybrid reporting, which combines manual chart review with electronic data submission, remained common in 2024. However, there is a clear push towards using Electronic Clinical Data Systems (ECDS) for more efficient and accurate reporting.
2. Data Completeness Issues for Race/Ethnicity Reporting: One notable challenge in 2024 was incomplete data on race and ethnicity. This issue led to gaps in healthcare delivery insights and created barriers for achieving equitable healthcare outcomes.
3. Misalignment in Provider Workflows: In some cases, provider workflows did not align with the documentation requirements for certain HEDIS measures. This misalignment created inefficiencies and reporting errors, highlighting the importance of continuous training and system updates.

III. HEDIS MY 2025 Updates

A. New Measures in 2025

The HEDIS 2025 update introduces several new measures designed to improve care delivery, particularly for women’s health and chronic disease management. These measures reflect ongoing trends in healthcare, emphasizing early intervention and more comprehensive care.

1. BPC-E (Blood Pressure Control) Replaces CBP: The Controlling Blood Pressure (CBP) measure is replaced by the Blood Pressure Control for Adults (BPC-E) measure in 2025. This updated metric places more emphasis on achieving and maintaining optimal blood pressure levels for individuals with hypertension, ultimately aiming to reduce the risk of stroke, heart disease, and kidney failure.
2. DBM-E (Digital Breast Mammogram) and FMA-E (Follow-Up After Mammogram): New measures focus on breast cancer screening and follow-up care. DBM-E emphasizes the use of digital mammography, while FMA-E tracks the follow-up care after a mammogram, ensuring timely intervention when necessary.
3. Expanded Focus on Behavioral Health and Substance Use: 2025 also sees an expanded focus on behavioral health and substance use treatment. Measures like IET (Initiation and Engagement of Alcohol and Other Drug Treatment) and FUM (Follow-Up After Emergency Department Visit for Mental Illness) are being strengthened to ensure that behavioral health needs are met more consistently.

B. Retirements and Consolidations

As with previous years, 2025 also brings retirements and consolidations of existing measures. This streamlining makes room for new priorities and eliminates redundancy in the reporting process.

1. CBP Retired, Cholesterol Measures Streamlined: The CBP measure is retired in favor of BPC-E, and certain cholesterol-related measures are streamlined to reduce overlap. This will simplify reporting for healthcare providers while maintaining a strong focus on cardiovascular health.
2. Pediatric Measures Consolidated: Several overlapping pediatric measures are consolidated to eliminate redundancy in tracking childhood care metrics. This change helps healthcare providers focus on the most impactful measures without the confusion of multiple overlapping metrics.

C. Key Specification Changes

HEDIS 2025 brings significant changes to the way reporting will be done. These adjustments aim to improve data collection efficiency and enhance focus on health equity.

1. Hybrid Reporting Phase-Out, ECDS-Only for More Measures: The transition from hybrid reporting (which uses a combination of manual and electronic reporting) to exclusively Electronic Clinical Data System (ECDS)-only reporting for most measures is set to continue. This shift will help streamline data collection and reporting processes.
2. Race/Ethnicity “Unknown” Category Reclassified: The race/ethnicity data category of “Unknown” will be reclassified as “No Data” in 2025. This adjustment ensures more accurate and actionable demographic information, which is critical for analyzing health disparities.
3. Gender Inclusivity Added to Sexual Health Measures: To better reflect patients’ diverse healthcare needs, gender inclusivity has been added to these measures. This change ensures that healthcare systems account for gender identity in their reporting of sexual health and related treatments.

IV. HEDIS 2024 vs 2025 — Comparative Breakdown

To help providers and payers prepare for the transition from HEDIS 2024 to 2025, here is a side-by-side comparison of the most significant updates, including new measures, retirements, and changes to reporting requirements. This breakdown will help clarify what to expect in the coming year.

A. New Measures

In 2025, the addition of BPC-E, DBM-E, and FMA-E represents a stronger emphasis on preventive care and chronic disease management. These new measures will help providers track and improve care for patients with hypertension, breast cancer, and other chronic conditions.

1. BPC-E (Blood Pressure Control) will focus on optimizing hypertension management, replacing CBP.
2. DBM-E (Digital Breast Mammogram) and FMA-E (Follow-Up After Mammogram) will improve breast cancer screening and follow-up.
3. Expanded Behavioral Health Focus in 2025 means that healthcare systems will need to prioritize mental health alongside physical health, improving outcomes in substance use and emergency mental health care.

B. Retired Measures

In 2025, some measures will be retired, including the CBP measure (replaced by BPC-E) and certain cholesterol-related metrics. This streamlining of measures reduces redundancy, making reporting more efficient and aligned with current healthcare practices.

1. CBP Measure: Retired to make room for BPC-E, which brings a more nuanced approach to blood pressure control.
2. Cholesterol Measures: Streamlined to simplify reporting and reduce overlapping metrics in cardiovascular care.

C. Reporting

The shift from hybrid to ECDS-only reporting for most measures reflects the growing importance of electronic data collection systems in healthcare. In 2025, more measures will require ECDS reporting, eliminating the need for manual chart reviews.

1. ECDS-Only Reporting: This marks a significant change in how healthcare providers report data, emphasizing the role of electronic health records and other digital tools.
2. Phase-Out of Hybrid Reporting: The transition to ECDS-only for more measures signals the healthcare industry’s move toward a fully digital future.

D. Equity

The emphasis on health equity continues to grow in 2025, with refinements to race and ethnicity stratification and the introduction of gender-inclusive measures.

1. Refined Stratification: The 2025 updates will improve race and ethnicity reporting by replacing the “Unknown” category with “No Data,” ensuring more accurate, actionable data on health disparities.
2. Gender Inclusivity: New measures will reflect gender inclusivity, particularly in sexual health assessments, ensuring that healthcare providers account for gender identity in their care processes.

V. Key HEDIS Measures and Acronyms Explained

To help healthcare providers and payers navigate the complexity of HEDIS reporting, here’s an in-depth look at the most important measures and acronyms. Understanding these will be crucial for maintaining compliance and optimizing quality care in 2025.

A. Cardiovascular & Chronic Disease Measures

Cardiovascular and chronic disease management remains a cornerstone of HEDIS measures. As these conditions continue to be major causes of morbidity and mortality, the metrics surrounding their management are critical to improving patient outcomes.

1. CBP: Controlling High Blood Pressure (retired in 2025, replaced by BPC-E)

• Focuses on maintaining blood pressure control for patients diagnosed with hypertension. In 2025, this measure will be replaced by BPC-E (Blood Pressure Control for Adults), which continues to prioritize blood pressure management but introduces more nuanced targets and processes.

2. OMW: Osteoporosis Management in Women

• Focuses on women aged 67 and older who have had a fracture and ensures they are receiving appropriate osteoporosis management. In 2025, this measure will be streamlined to improve data collection and enhance tracking of care.

3. SPC: Statin Therapy for Cardiovascular Disease

• Ensures that patients with cardiovascular disease receive appropriate statin therapy to lower cholesterol and reduce the risk of heart attacks and strokes.

4. PCR: Persistence of Beta-Blocker Treatment After a Heart Attack

• Measures whether patients who have had a heart attack continue to take beta-blockers as prescribed, which helps reduce the risk of subsequent heart events.

B. Preventive & Cancer Screening Measures

Preventive care is a core component of healthcare quality, and HEDIS measures focus on ensuring that screenings for various conditions, including cancer, are conducted regularly.

1. PPC: Prenatal and Postpartum Care

• Measures the timely prenatal and postpartum care provided to women during pregnancy and after childbirth. This ensures that women receive the care they need to reduce risks during and after pregnancy.

2. COA: Care for Older Adults

• Focuses on providing comprehensive care for older adults, including screening for functional status, pain, and depression, ensuring that healthcare systems meet the complex needs of aging populations.

3. WCC: Weight Assessment and Counseling for Children/Adolescents

• This measure tracks whether children and adolescents have their weight assessed and are counseled about healthy behaviors. It helps address the growing concerns around childhood obesity and related conditions.

C. Behavioral Health & Substance Use Measures

Behavioral health and substance use have become critical areas of focus in healthcare, with HEDIS updating its measures to ensure better screening, treatment, and follow-up for patients in need of mental health services.

1. IET: Initiation and Engagement of Alcohol and Other Drug Treatment

• This measure evaluates whether patients who are diagnosed with alcohol or other drug dependence begin treatment and are engaged in ongoing care, reducing the risk of relapse.

2. FUM: Follow-Up After Emergency Department Visit for Mental Illness

• Focuses on ensuring that a mental health provider promptly follows up with individuals who visit the emergency department for mental health reasons to continue their care and avoid crises.

3. HBD: Depression Screening and Follow-Up for Adolescents/Adults

• Ensures that both adolescents and adults are regularly screened for depression and provided with appropriate follow-up care, addressing the critical need for mental health services.

Related read: Streamlining Behavioral Healthcare with Epic EHR Integration: Enhancing Efficiency and Patient Care

D. Digital & Equity-Driven Measures

The push for digital health solutions and health equity is reflected in HEDIS 2024 and 2025 updates, with several measures designed to incorporate digital tools and address disparities in healthcare delivery.

1. EED: Depression Screening with ECDS Reporting

• This measure uses Electronic Clinical Data Systems (ECDS) for reporting depression screening, ensuring more accurate and efficient data collection.

2. APM: Adult Preventive Measures

• A broad category that includes preventive services like immunizations, screenings, and health counseling for adults. It is designed to improve the quality and effectiveness of preventive healthcare for adults.

3. KED: Kidney Health Evaluation for Patients with Diabetes

• Ensures that diabetic patients are screened for kidney disease and receive necessary evaluations to prevent kidney failure, which is a common complication of diabetes.

VI. Technical Deep Dive Reporting and Data in 2025

As healthcare increasingly relies on digital tools and data integration, understanding the technical aspects of HEDIS reporting becomes crucial for providers and payers. The 2025 updates bring several changes that emphasize the use of Electronic Clinical Data Systems (ECDS), alongside the continued phase-out of hybrid reporting.

A. ECDS in Action

The shift toward Electronic Clinical Data Systems (ECDS) for reporting reflects a broader trend in healthcare toward digital data collection and interoperability. ECDS helps pull structured data from multiple sources, including Electronic Health Records (EHRs), Health Information Exchanges (HIEs), and registries, thereby improving the accuracy and efficiency of reporting.

1. Pulling Structured Data from EHRs, HIEs, and Registries: ECDS enables extraction from structured sources, reducing the need for manual chart reviews and improving the consistency of reported outcomes.
2. Standards: HL7, C-CDA, FHIR APIs: The technical standards driving ECDS are based on widely adopted protocols, including HL7, C-CDA, and FHIR (Fast Healthcare Interoperability Resources) APIs. These standards ensure that data can be exchanged efficiently and securely across healthcare systems.

B. The Sunset of Hybrid Reporting

Hybrid reporting, which combines manual chart reviews with electronic data submission, will continue to phase out as more measures transition to ECDS-only reporting in 2025. This transition aims to eliminate manual data-entry errors and streamline providers’ reporting processes.

1. Manual Chart Review Phased Out: As ECDS becomes the primary reporting mode, the need for manual chart review will decrease. This change will simplify the reporting process and reduce the administrative burden on healthcare providers.
2. Digital Workflows Mandatory for BPC-E, DBM-E, and FMA-E: These measures will require digital workflows for reporting. This change reflects the increasing reliance on digital tools for managing patient care and collecting accurate data.

C. Data Interoperability Challenges

Although ECDS reporting offers numerous advantages, it also poses challenges related to data interoperability. Ensuring that data flows seamlessly across systems without gaps will be crucial for the success of HEDIS reporting in 2025 and beyond.

1. Incomplete BP Documentation for CBP/BPC-E: One ongoing challenge is incomplete blood pressure documentation for measures like CBP (which will be replaced by BPC-E). Healthcare systems must ensure that all relevant data, including blood pressure readings, is captured accurately.
2. Mammogram Order-Result Loop Gaps: There are also gaps in the mammogram order-result loop, where the process from ordering to reporting results may be incomplete. This can undermine the effectiveness of measures such as DBM-E and FMA-E.
3. Substance Use (IET) Requires Multiple System Linkages: Tracking and reporting substance use treatment requires linking multiple systems, including EHRs, treatment databases, and follow-up care systems. Ensuring data flows smoothly between these systems is key to accurate reporting for measures like IET.

VII. Health Equity and Stratification Updates

Health equity remains a priority in HEDIS, with 2025 updates refining how demographic data, such as race and ethnicity, are collected and used to assess healthcare quality. The changes in this area reflect the growing recognition that healthcare systems must address disparities and improve care for underserved populations.

A. 2024 Start → 2025 Refinement

Health equity measures have been steadily evolving, with 2025 bringing more refined practices for capturing and analyzing demographic data. This ensures that disparities in care delivery are identified and addressed.

1. Race/Ethnicity Stratification Introduced in 2024: Starting in 2024, HEDIS introduced race and ethnicity stratification to help identify and analyze healthcare disparities. This allowed healthcare organizations to monitor outcomes by racial and ethnic categories, helping to pinpoint areas for improvement.
2. 2025 Updates: Cleaner Mapping, “Unknown” Becomes “No Data”: In 2025, the race/ethnicity “Unknown” category will be reclassified as “No Data.” This refinement ensures that data is more accurately represented, making it easier for healthcare providers to identify gaps in care and make data-driven decisions to reduce health disparities.

B. Gender Inclusivity

The healthcare industry is increasingly recognizing the importance of gender identity in patient care. To reflect this, 2025 HEDIS updates have expanded to include gender inclusivity in certain sexual health measures.

1. Chlamydia and Preventive Measures Expanded to Reflect Gender Identity: For the first time, HEDIS measures related to sexual health, such as chlamydia screenings, will include gender identity. This change ensures that healthcare systems can better serve transgender and non-binary individuals, promoting more inclusive and equitable care.

C. Operationalizing Equity Data

Collecting accurate equity data is only the first step; healthcare organizations must also act on this data to improve patient care. Operationalizing health equity requires standardized data collection practices and staff training to ensure accuracy.

1. Standardized SOGI (Sexual Orientation and Gender Identity) Collection: To better address health equity, standardized SOGI data collection will be increasingly required. This allows healthcare providers to understand patients’ unique needs based on their sexual orientation and gender identity.
2. Staff Training for Intake Accuracy: Healthcare organizations must train staff to accurately collect and enter demographic data. This is crucial for ensuring that the information is used effectively to identify disparities and improve care.
3. Supplement with Registries and Surveys: Data from registries and patient surveys will supplement direct intake information, providing a fuller picture of patients’ health needs. This will help create more comprehensive profiles and ensure equitable care delivery.

VIII. Preparing for HEDIS 2025 — Roadmap for Providers & Payers

With significant updates coming in 2025, healthcare providers and payers need to begin preparing well in advance. This roadmap outlines the key steps needed to ensure your organization is ready for the upcoming HEDIS updates, including reviewing specifications, upgrading infrastructure, and training care teams.

1. Review NCQA 2025 Specs for New/Retired Measures

• The first step in preparing for HEDIS 2025 is to carefully review the NCQA specifications for the new and retired measures. These specifications will provide the detailed requirements for reporting, as well as the definitions and thresholds for the measures. Understanding these changes early is critical for aligning your data collection and reporting practices with the latest guidelines.

2. Conduct Data Gap Analysis (BP, Mammograms, Behavioral Health Follow-Ups)

• Healthcare organizations should conduct a thorough data gap analysis to identify any missing or incomplete data. For example, gaps in blood pressure documentation for BPC-E or mammogram follow-up data for DBM-E and FMA-E must be addressed before reporting. Similarly, organizations should ensure they have comprehensive data for behavioral health follow-up measures, such as IET and FUM.

3. Upgrade Infrastructure for ECDS Reporting (FHIR APIs, Registries)

• As more measures transition to ECDS-only reporting, healthcare organizations will need to upgrade their infrastructure to support data integration and electronic reporting. This may include implementing FHIR APIs, improving data sharing with registries, and ensuring that Electronic Health Record (EHR) systems can efficiently meet ECDS requirements.

4. Train Care Teams on Documentation Needs

• Healthcare providers must ensure their clinical teams are trained on the updated HEDIS 2025 documentation requirements. This includes capturing accurate data for new measures, such as BPC-E, and ensuring that the required information for existing measures is documented properly in EHRs.

5. Pilot Dry-Run Reports for BPC-E, FUM, IET

• Before submitting official reports, conduct pilot dry runs of the new measures, such as BPC-E (Blood Pressure Control), FUM (Follow-Up After Mental Illness), and IET (Initiation and Engagement of Alcohol and Other Drug Treatment). This will allow organizations to identify data-collection or reporting issues early, reducing the risk of non-compliance.

6. Validate Demographic Data for Equity Reporting

• As health equity becomes a more prominent focus in HEDIS 2025, it is essential to validate demographic data for race, ethnicity, and gender identity. Ensure your systems can accurately capture and report this data, and review any processes that may result in incomplete or inaccurate demographic information.

IX. Timeline for MY 2025 Reporting

Having a clear timeline is crucial for healthcare providers and payers to stay on track with the HEDIS reporting process. The following timeline outlines key milestones for the 2025 measurement year, providing a structured plan to ensure readiness.

1. Summer 2024: Specs Released

• NCQA will release the HEDIS 2025 specifications in mid-2024. This will include detailed guidelines for all new, revised, and retired measures, along with the reporting requirements for each. Providers and payers should review these specs promptly to begin preparing.

2. Fall 2024: Audit Workflows

• During the fall of 2024, healthcare organizations should audit their workflows to ensure they are aligned with the new HEDIS 2025 requirements. This is the time to identify any gaps in data collection processes and ensure that systems and staff are prepared to handle the changes.

3. January 2025: Measurement Year Begins

• The measurement year for HEDIS 2025 begins on January 1, 2025. From this point, healthcare organizations will start collecting data for the various HEDIS measures, including those that require reporting through ECDS or manual methods.

4. Summer 2025: Submission Deadlines

• The official submission deadlines for HEDIS 2025 will occur in the summer of 2025. This is when organizations will submit their final data to NCQA for accreditation and reporting purposes. Providers should ensure that all data is complete, accurate, and ready for submission before the deadlines.

X. Beyond 2025 — The Future of HEDIS

As healthcare continues to evolve, so too will HEDIS measures. The updates in 2025 mark a critical milestone in the ongoing transformation toward more digital, data-driven healthcare systems. Looking ahead to 2030 and beyond, several trends are poised to shape the future of HEDIS reporting and healthcare quality metrics.

A. Toward 2030

1. 100% Digital Submission: By 2030, it is expected that all HEDIS measures will be reported exclusively digitally. The reliance on manual chart reviews and hybrid reporting will be phased out entirely, making way for a fully integrated, electronic system for data submission. This shift will streamline the reporting process, reduce errors, and improve the speed and accuracy of quality assessments.
2. All Measures ECDS-Only: Every HEDIS measure will eventually require reporting through Electronic Clinical Data Systems (ECDS), eliminating the need for paper-based or hybrid reporting. This will create a more seamless data flow and ensure that healthcare systems can provide real-time insights into care quality and outcomes.

B. Growth of SDOH in HEDIS

Social Determinants of Health (SDOH) are increasingly recognized as critical factors influencing health outcomes. Moving forward, HEDIS will likely incorporate more measures related to SDOH, including housing, food insecurity, and transportation.

1. New Measures on Housing, Food Insecurity, and Transportation: As healthcare providers look to address broader health beyond clinical care, new SDOH measures will be added to HEDIS. These measures will help healthcare systems understand the social factors affecting patient care and implement strategies to address these challenges.
2. Integration with Community Health: SDOH measures will be more closely integrated into community health initiatives, encouraging healthcare systems to collaborate with local organizations to address the root causes of health disparities.

C. Value-Based Care Alignment

As the healthcare industry continues to shift toward value-based care, HEDIS will play a more prominent role in tracking outcomes and incentivizing quality care delivery. The integration of HEDIS measures into value-based care models will help align financial incentives with patient health outcomes.

1. HEDIS Integrated into Contracts and Real-Time Incentive Tracking: Healthcare providers and payers will increasingly use HEDIS measures to track performance in real-time. This data will be used to determine reimbursement rates and bonuses, ensuring that providers are rewarded for delivering high-quality, cost-effective care.
2. Real-Time Reporting for Value-Based Care: In the future, HEDIS data may be submitted and analyzed in real-time, providing more timely insights into care quality. This shift will enable quicker interventions and adjustments in care delivery, improving patient outcomes.

XI. How Mindbowser Can Help

Mindbowser partners with healthcare providers and payers to successfully navigate the evolving HEDIS landscape. Our expertise in digital solutions, data integration, and workflow optimization ensures your organization is prepared for the upcoming changes in 2025. From gap analysis and ECDS readiness to training and pilot programs, Mindbowser offers tailored strategies to improve operational efficiency and compliance. Let us help you optimize your reporting processes and stay on track with the latest HEDIS measures.