Quality ManagementMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingOctober 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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Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc., independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Providers who are contracted with Anthem Blue Cross and Blue Shield to serve Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for Aging through an accountable care organization (ACO), participating medical group (PMG) or Independent Physician Association (IPA) are to follow guidelines and practices of the group. This includes but is not limited to authorization, covered benefits and services, and claims submittal. If you have questions, please contact your group administrator or your Anthem network representative.

MULTI-BCBS-CRCM-068036-24-CPN67348

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