MY 2026: Breaking down the latest HEDIS Technical Specifications

Cotiviti Blog · 10 months ago · 183 views

As health plan leaders prepare for the next cycle of quality reporting, the HEDIS® Measurement Year (MY) 2026 Technical Specifications represent a significant shift for measure design and reporting requirements. The National Committee for Quality Assurance (NCQA) continues to refine HEDIS measures to better reflect the evolving landscape of healthcare quality assessment, introducing seven new measures for MY 2026 alongside meaningful updates to existing ones. These changes affect risk-adjusted outcomes, electronic clinical data system (ECDS) reporting, and member descriptive information. Understanding these updates is essential for plans to ensure compliance and maximize performance. We compared the MY 2026 specifications against the materials that NCQA proposed as part of the Public Comment period to help pinpoint adjustments from public feedback and submitted several questions regarding the measures to share additional insights. Here, we offer a structured breakdown of confirmed changes, clarifications, and specific strategies to enable plans to prepare for MY 2026.

As health plan leaders prepare for the next cycle of quality reporting, the HEDIS^® Measurement Year (MY) 2026 Technical Specifications represent a significant shift for measure design and reporting requirements. The National Committee for Quality Assurance (NCQA) continues to refine HEDIS measures to better reflect the evolving landscape of healthcare quality assessment, introducing seven new measures for MY 2026 alongside meaningful updates to existing ones. These changes affect risk-adjusted outcomes, electronic clinical data system (ECDS) reporting, and member descriptive information.

Understanding these updates is essential for plans to ensure compliance and maximize performance. We compared the MY 2026 specifications against the materials that NCQA proposed as part of the Public Comment period to help pinpoint adjustments from public feedback and submitted several questions regarding the measures to share additional insights. Here, we offer a structured breakdown of confirmed changes, clarifications, and specific strategies to enable plans to prepare for MY 2026.