Quality Management Optimizing HEDIS & STARSAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageOctober 23, 2024

HEDIS Measure Tips — Appropriate Testing for Pharyngitis (CWP) 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 evaluates the episodes for members 3 years of age and older where the member was diagnosed with pharyngitis, dispensed an antibiotic, and received a group A streptococcus (strep) test for the episode on or between July 1 of the year prior to the measurement year to June 30 of the measurement year.

Refer to attachments to view full details.

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

Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of Maine, Inc. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Plans offered by AMH Health, LLC., a joint venture between MaineHealth and Anthem Partnership Holding Company, LLC. AMH Health is an independent licensee of the Blue Cross Blue Shield Association.

MEAMH-CR-067990-24-CPN67342, MULTI-BCBS-CRCM-067995-24-CPN67342

ATTACHMENTS: HEDIS Measure Tips — Appropriate Testing for Pharyngitis (CWP) 2025 - AMH Health, LLC (pdf - 0.77mb), HEDIS Measure Tips — Appropriate Testing for Pharyngitis (CWP) 2025 - Anthem Blue Cross Blue Shield (pdf - 0.74mb)