NCQA released the HEDIS® MY 2027 specifications on August 3. Get a rapid readout of the confirmed changes, the hybrid retirement timelines, and what your quality team should check first.
Why this matters now
NCQA on Monday released HEDIS® Measurement Year 2027 Volume 2: Technical Specifications for Health Plans, giving quality teams their first complete look at the measure set for the 2027 season. The August 3 release includes the MY 2027 Medication List Directory alongside the technical specifications for long-term services and supports measures. The notification of changes memo accompanying the release spans three measurement years, so this one document sets your roadmap through MY 2028.
The changes NCQA confirmed
Effective now for MY 2026: Two technical updates apply to the season already underway. Cervical Cancer Screening (CCS-E) expands the high-risk HPV test value set to include self-collected vaginal samples, following updated American Cancer Society guidelines. Social Need Screening and Intervention (SNS-E) drops HCPCS code G0136 after CMS redefined the code in the CY 2026 Physician Fee Schedule.
Hybrid retirement holds its schedule: The memo reconfirms the measure-by-measure path to retiring the hybrid method by MY 2029. Glycemic Status Assessment for Patients With Diabetes (GSD) gains an optional ECDS reporting method in MY 2027. Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC) retires in MY 2029 while NCQA develops a replacement. Prenatal and Postpartum Care (PPC) gets an ECDS and risk-based replacement by MY 2028. Transitions of Care (TRC) and Care for Older Adults (COA) keep the hybrid method until MY 2029, with their ECDS versions now arriving in MY 2028.
LTSS goes FHIR: The LTSS measure template moves to a FHIR-aligned format. Measure intent and calculation requirements stay the same. Treat it as another marker of where the whole portfolio is headed.
Denied claims land in MY 2028: NCQA will remove the denied claims exclusion from 21 overuse, utilization, and risk-adjusted utilization measures, including Plan All-Cause Readmissions and Emergency Department Utilization. Rates will move with no change in the care delivered. The advance notice gives you two seasons to model the impact.
Check the new measures first
Seven proposed measures went through public comment in March: Continuous Glucose Monitoring Utilization for Patients With Diabetes (CGD-E), Follow-Up After Positive Colorectal Cancer Non-Invasive Screening Test (COF-E), a measure for intimate partner violence screening and follow-up, three person-centered outcome measures, and prenatal syphilis screening and follow-up. The final Volume 2 confirms which proposals made the specifications and in what form. Both headline candidates, CGD-E and COF-E, follow the ECDS-first pattern, so the data question comes before the performance question.
What this means for health plans
The release favors teams treating each August as part of a digital strategy rather than a one-off project. Plans with mature pharmacy, device, and clinical data feeds enter the CGM measure a step ahead. Plans still leaning on chart abstraction have a clear runway: three hybrid seasons remain before MY 2029, enough time to build ECDS feeds if the work starts now. And the denied claims change gives your Stars and analytics teams two full seasons to set a fresh baseline for MY 2028 utilization benchmarks.
Questions to consider
- Which of the seven proposed measures made your final gap-closure list for 2027?
- Who owns the redline review of the new specifications, and by what date?
- How much hybrid lift does your Stars forecast still assume for MY 2028?
Quality leaders will work through the new specifications together at the 16th Annual HEDIS® & Quality Improvement Summit, November 3-5, in Baltimore.
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