For physicians

HEDIS and value-based care

Moving from volume-based care toward risk-bearing arrangements changes what a diagnostic is for. It stops being an event and becomes the evidence that a population is being managed.

This page is about clinical documentation and population management. It makes no claim about payment, contract terms or financial outcomes of any arrangement.

What changes under risk

Under volume-based care, a practice is measured by activity. Under a risk-bearing or quality-adjusted arrangement, it is measured by whether the panel is documented, stratified and managed. That shifts the useful question from “was something done” to “is the population characterized well enough to manage it.”

A panel where vascular, autonomic, small-fiber, metabolic, balance and cognitive status are measured is characterized. A panel where they are inferred is not.

Common HEDIS domains this testing supports

DomainWhat the assessment contributes
Adult BMI assessmentHeight, weight and body composition recorded with a documented follow-up plan
Diabetes care — blood pressure controlSeated and, where indicated, positional blood pressure
Diabetes care — glycemic controlGlycemic markers from the laboratory panel
Diabetes care — nephropathy and foot assessmentRenal markers, plus sudomotor and vascular foot data
Fall risk managementObjective vestibular, sensory and orthostatic measurement
Care for older adults — functional statusBalance, body composition and cognitive baseline
Medication reconciliationA complete list is a precondition for interpreting the testing
Measure specifications vary by plan and by year; confirm current definitions with the plan.

Risk stratification, not just measure capture

The more useful application in a risk arrangement is stratification. A panel can be sorted by objective vascular and autonomic status rather than by diagnosis codes, which is a materially different ranking. Patients with measurable small-fiber loss and reduced perfusion are the ones who go on to have foot complications; patients with combined vestibular and cognitive findings are the ones who go on to fall. Both groups are identifiable in advance.

Documentation discipline

Three habits make the data usable rather than merely present.

  1. Record the conditions. Fasting state, caffeine, nicotine, time of day and medication timing all move these measurements. A reading without its conditions is not comparable.
  2. Use the same instrument and the same technique. Reproducibility is what makes a trend real. Staffing and workflow covers this.
  3. File results as structured data where possible. A scanned report satisfies a chart requirement and cannot be queried across a panel. EMR integration.

For patients: the same subject written for the person having the assessment is at understanding your results.

Talk to someone about testing

Tell us what you are trying to find out and we will explain which Measura assessments answer that question, what each one involves, and how the results are reviewed with a clinician.

4477 Woodson Rd, Suite 201, St. Louis, MO 63134. Monday to Friday, 9:00 a.m. to 5:00 p.m. Please do not send symptoms, diagnoses or images through a web form — a website form is not a secure medical channel. Call us with clinical detail.

Common questions

Does this replace our existing quality reporting workflow?

No — it supplies better inputs to it. Which domains it supplies.

How do we stratify a panel with this data?

By measured vascular and autonomic status rather than by diagnosis codes, which produces a different and more predictive ranking. Making screening reproducible.

What if results arrive as PDFs?

They satisfy the chart requirement and cannot be queried, which limits their usefulness under risk. Getting results into the chart.

Medically reviewed by Dr. Gurpreet Singh Padda, MD, MBA, MHP, medical director of Measura. Last reviewed .