BCS-E
Breast cancer screening
HEDISStars
- Reward mechanic
- Gift card on completed mammogram
- Evidence path
- Claim · CPT 77067
Measures
The measures we move.
A working catalog of the HEDIS, Stars, CAHPS, and health-equity measures the platform is built to close, with the reward mechanic and evidence path for each. If it's on this list, we've modeled how to close it.
Showing 30 of 30 measures
Prevention
COL-E
Colorectal cancer screening
HEDISStars
- Reward mechanic
- Escalating reward: kit → colonoscopy
- Evidence path
- Claim or lab · Cologuard / FIT / CPT 45378
CCS
Cervical cancer screening
HEDIS
- Reward mechanic
- Gift card on completed screening
- Evidence path
- Claim · CPT 88175 / 87624
CIS
Childhood immunization status
HEDIS
- Reward mechanic
- Caregiver reward on 10-vaccine complete
- Evidence path
- Claim + state registry
IMA
Immunizations for adolescents
HEDIS
- Reward mechanic
- Caregiver reward on Tdap + HPV + MenACWY
- Evidence path
- Claim + registry
AWV
Annual wellness visit
StarsCAHPS
- Reward mechanic
- Gift card on visit confirmation
- Evidence path
- Claim · G0438 / G0439
CBP
Controlling high blood pressure
HEDISStars
- Reward mechanic
- Reward on in-range reading + verified refill
- Evidence path
- Provider worklist + Rx fill
HBD
HbA1c control for diabetes
HEDISStars
- Reward mechanic
- Reward on HbA1c < 8 result
- Evidence path
- Lab · LOINC 4548-4
KED
Kidney health evaluation, diabetes
HEDISStars
- Reward mechanic
- Reward on eGFR + uACR both completed
- Evidence path
- Lab · LOINC 33914-3 + 14959-1
EED
Eye exam for diabetes
HEDISStars
- Reward mechanic
- Reward on retinal exam completed
- Evidence path
- Claim · CPT 2022F / 2024F
SPC
Statin therapy for cardiovascular
HEDISStars
- Reward mechanic
- Reward on statin fill + PDC ≥ 80%
- Evidence path
- Pharmacy claim
PDC-DM
Medication adherence, diabetes
Stars
- Reward mechanic
- Monthly reward on refill on time
- Evidence path
- Pharmacy claim
PDC-RASA
Medication adherence, hypertension
Stars
- Reward mechanic
- Monthly reward on refill on time
- Evidence path
- Pharmacy claim
PDC-Statin
Medication adherence, statins
Stars
- Reward mechanic
- Monthly reward on refill on time
- Evidence path
- Pharmacy claim
ADD-E
ADHD follow-up care
HEDIS
- Reward mechanic
- Caregiver reward on 30-day + continuation
- Evidence path
- Claim · outpatient E/M
FUH
Follow-up after MH hospitalization
HEDISStars
- Reward mechanic
- Reward on 7-day and 30-day follow-up
- Evidence path
- Claim + care manager confirmation
FUM
Follow-up after ED for mental illness
HEDIS
- Reward mechanic
- Reward on 7-day follow-up
- Evidence path
- Claim
IET
Initiation & engagement of SUD
HEDIS
- Reward mechanic
- Reward on initiation + engagement
- Evidence path
- Claim
DEP-REM
Depression remission or response
HEDISStars
- Reward mechanic
- Reward on PHQ-9 follow-up completed
- Evidence path
- Dialogue survey + provider worklist
PROMs
Patient-reported outcomes
CAHPScustom
- Reward mechanic
- Reward on completed dialogue survey
- Evidence path
- Two-way SMS / IVR
CAHPS-GR
Rating of health plan
StarsCAHPS
- Reward mechanic
- Journey rewards on service touchpoints
- Evidence path
- Attributed touch history
CAHPS-GP
Getting needed care
StarsCAHPS
- Reward mechanic
- Reward on care-navigator engagement
- Evidence path
- Care mgmt system event
HRA
Health risk assessment
MAMedicaid
- Reward mechanic
- Reward on completed HRA
- Evidence path
- Dialogue survey
SDOH-Z
SDOH screening (Z-code capture)
HEDISHEI
- Reward mechanic
- Reward on completed screening
- Evidence path
- Claim + survey
HEI
Health equity index contributions
Stars 2027
- Reward mechanic
- Boosted rewards for LIS / dual / disability
- Evidence path
- Eligibility + measure event
REDET
Medicaid redetermination
Medicaid
- Reward mechanic
- Reward on form submitted
- Evidence path
- State + plan confirmation
OEV
Well-child visits, first 30 months
HEDIS
- Reward mechanic
- Caregiver reward on visit cadence
- Evidence path
- Claim
W30
Well-child visits, 3–21
HEDIS
- Reward mechanic
- Caregiver reward on annual visit
- Evidence path
- Claim
PPC
Prenatal & postpartum care
HEDIS
- Reward mechanic
- Escalating rewards across trimester + PP
- Evidence path
- Claim + provider worklist
TFL-CH
Tobacco-free lifestyle attestation
Wellness
- Reward mechanic
- Premium reduction on attestation
- Evidence path
- Signed attestation + biometric
Measure specifications reference NCQA HEDIS, CMS Star Ratings, and AHRQ CAHPS. Reward mechanics reflect platform capability, not a plan-specific program design.