Quality ManagementMedicare AdvantageMedicaidOctober 29, 2024

HEDIS Measure Tips — Appropriate Treatment for Upper Respiratory Infection (URI) 2025

Healthcare Effectiveness Data Information Set® (HEDIS) is a widely used set of performance measures developed and maintained by NCQA. To help you better serve our members and drive improved efforts surrounding HEDIS, we have compiled some tips and best practices. With your help, we can continually build towards a future of shared success.

This HEDIS measure looks at the percentage of episodes for members 3 months of age and older with a diagnosis of upper respiratory infection (URI) that did not result in a dispensed antibiotic dispensing event.

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HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

Anthem Blue Cross is the trade name of Blue Cross of California. Anthem BC Health Insurance Company is the trade name of Anthem Insurance Companies, Inc. Anthem Blue Cross, Anthem Blue Cross Life and Health Insurance Company, Anthem BC Health Insurance Company, and Blue Cross of California Partnership Plan, Inc. are independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Blue Cross of California is contracted with L.A. Care Health Plan to provide Medi-Cal Managed Care services in Los Angeles County.

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ATTACHMENTS: HEDIS Measure Tips — Appropriate Treatment for Upper Respiratory Infection (URI) 2025 - Anthem Blue Cross (pdf - 0.9mb)