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California Health & Wellness is no longer a Medi-Cal plan starting January 1, 2024. Regardless of the county you live in, your Medi-Cal service and benefits will not be impacted by the health plan changes since you will be assigned to a new health plan. The county you live in determines your new health plan. Learn more
California Health & Wellness is no longer a Medi-Cal plan starting January 1, 2024. Regardless of the county you live in, your Medi-Cal service and benefits will not be impacted by the health plan changes since you will be assigned to a new health plan. The county you live in determines your new health plan. Learn more

HEDIS Measures

Date: 08/30/19

HEDIS Measures

California Health & Wellness Plan (CHWP) provides tips and tools to make sure providers gain a better understanding of Healthcare Effectiveness Data and Information Set (HEDIS®) measures.  

HEDIS tools on the provider portal

There is the new HEDIS Quick Reference Guide (QRG) and provider tip sheets that detail various HEDIS measures. Go to the provider portal and select Quality Improvement (QI) Program to view HEDIS tools, such as:

  • HEDIS Quick Reference Guide (QRG).
  • HEDIS Measures & Billing Codes.
  • Provider Tip Sheets.

Screening for lead

CHWP reminds providers that all children enrolled in Medicaid are required to have a blood lead screening test at ages 12 and 24 months. Children ages 24 months to 6 years who haven’t been screened in the past should have a blood lead screening test. The Centers for Disease Control and Prevention (CDC) note there is no safe blood lead level.  

  • Refer to the HEDIS QRG (under Quality Improvement (QI) program tab) for relevant codes to use.

Lead poisoning can cause intellectual, developmental and physical problems. Yet because it doesn’t have obvious symptoms, it may be easily overlooked.

The CDC reports that children living in 4 million U.S. households are being exposed to lead. High lead levels can damage the brain and nervous system. They can also cause developmental and growth delays, learning or behavioral problems, and hearing and speech problems.

Immunizations for teens

The HEDIS measure Immunizations for Adolescents assesses 13-year-olds who had one dose of meningococcal vaccine, one Tdap vaccine and the complete HPV series.

  • Refer to the HEDIS QRG (under Quality Improvement (QI) program tab) for relevant codes to use.
  • Refer to the California Immunization Registry (CAIR) website at www.cairweb.org for information on tracking and submitting immunization records.

For more information about the HEDIS measures, go to www.ncqa.org.