May 2024

We’re reminding members about important preventive cancer screenings

Blue Cross Blue Shield of Michigan and Blue Care Network want to help members live their healthiest lives and help providers close gaps in care. We’ll begin sending targeted communications throughout May and in to early June to members who haven’t had recommended cancer screenings to encourage them to discuss their cancer risk and testing options with their physicians. Health care providers can help members by scheduling time to discuss the importance of cervical, breast and colorectal cancer screenings.

Providers play an important role in this preventive care by discussing lifestyle, family history and a screening schedule that’s right for each patient.

Effective cancer screening and early detection has led to declining death rates from cancer.

The Healthcare Effectiveness Data, or HEDIS^®, measures for screening are below:

Colorectal cancer

The Colorectal Cancer Screening HEDIS^® Star Measure assesses patients ages 45 to 75 who had appropriate screenings for colorectal cancer. Colonoscopy is the gold standard for colorectal cancer screening. Providers can discuss alternative options for patients who are reluctant to have one.

Providers can discuss lifestyle modifications for members. More than half of all cases and deaths are attributable to modifiable risk factors, such as smoking, an unhealthy diet, high alcohol consumption, physical inactivity and excess body weight.

Breast cancer

Breast cancer is the second most common cancer in women, according to the American Cancer Society.
The Breast Cancer Screening HEDIS^® Star Measure assesses female patients ages 50 to 74 who had a mammogram to screen for breast cancer in the past two years.

Cervical cancer

Cervical cancer is the fourth most common cancer in women globally, according to the World Health Organization.

The HEDIS measure for cervical cancer screening uses the following criteria for those who were recommended for routine screening:

Women 21 to 64 years of age who had cervical cytology performed within the last three years
Women 30 to 64 years of age who had cervical high-risk human papillomavirus (hrHPV) testing performed within the last five years
Women 30 to 64 years of age who had cervical cytology/high-risk human papillomavirus (hrHPV) cotesting within the last five years

New reporting system for 2024 HEDIS measures

The National Committee for Quality Assurance has developed a new reporting standard for HEDIS, called electronic clinical data systems, or ECDS. This reporting standard defines the data sources and types of structured data acceptable for use for a measure.

Data systems that may be eligible for ECDS reporting include administrative claims, clinical registries, health information exchanges, immunization information systems, disease and case management systems, and electronic health records.

HEDIS quality measures reported using ECDS inspire innovative use of electronic clinical data to document high-quality patient care, according to NCQA.

Breast cancer and colorectal cancer screenings are ECDS measures for 2024.

Information about ECDS is available on the NQCA** website.

Healthcare Effectiveness Data Information Set, or HEDIS^®, is a registered trademark of the National Committee for Quality Assurance (NCQA).

**Blue Cross and BCN don’t own or control this website.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2023 American Medical Association. All rights reserved.