ACAP submitted a comment letter on Proposed Changes to Existing Measure for HEDIS®1 MY 2024: Breast Cancer Screening.
In the letter, ACAP shares its support for the Addition of the Population Age 40-49 and the New Stratification, if approved by USPSTF, and notes concerns regarding the implementation timeline.
In particular, the letter notes the following:
- Since the USPSTF has not yet updated their guidelines to align with the American Cancer Society (ACS) and American College of OBGYN (ACOG), ACAP plans do not
agree to the age expansion for MY 2024, as there might not be uniform application of mammogram screenings for the 40-49 age group in all provider settings.
- Since USPSTF won’t finalize the recommendation to add the new age band until 2024, adding it to the measure for MY 2024 reporting after the start of the measurement year will be operationally challenging for plans.
- ACAP plans recommend including the new age group in the BCS-E rate as a data collection/monitoring measure for 2 years to give providers the opportunity to educate,
promote, and order the mammogram screenings for that age group. We recommend inclusion of BCS-E as a full reporting measure for MY2026.
- Several plans also noted various concerns with proposed changes to the Participation Period. Shortening the enrollment period for Medicaid plans also will create a disadvantage compared to Commercial & Medicare plans, who will continue to have the 2-year enrollment requirement.
To read the letter in full, including additional questions asked by ACAP, click the PDF linked on the right.