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HEDIS MY 2027 arrives with a digital, outcomes-based mandate

Prepare for HEDIS MY 2027 changes and the shift to digital transition with 6 new measures and ECDS shifts.

NCQA's HEDIS MY 2027 changes bring 6 new measures and ECDS shifts. Prepare your health plan for the MY 2027 digital transition with Reveleer.

September 15, 2026

Written by: Natalie Schibell, VP, Product Marketing, Reveleer

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NCQA released the HEDIS® Measurement Year (MY) 2027 Volume 2: Technical Specifications for Health Plans on August 3, and the update confirms that quality improvement is becoming more digital, longitudinal, and outcomes-based. The HEDIS MY 2027 changes add six new measures, update three existing measures, and move one additional measure to Electronic Clinical Data Systems (ECDS) reporting. NCQA also opened an ad hoc public comment period, running through August 17, 2026, to collect feedback on ten measures proposed for retirement.

After reviewing the new specifications and weighing in on the proposed measure retirements, quality and Stars leaders should start planning for a HEDIS measurement year that depends on more structured clinical data than any before it.

Six new measures, three updates, and one ECDS transition

The HEDIS MY 2027 specifications introduced six new measures, in line with the volume of additions in years past. The six additions aren't uniformly outcome-focused: only the three Person-Centered Outcome measures (GID-E, GIF-E, GIA-E) measure outcomes directly, while COF-E and PSY-E are screening and follow-up measures and CGD-E is a utilization measure. Each addition targets a documented care gap, including rising congenital syphilis cases, incomplete colorectal cancer follow-up, underused continuous glucose monitoring, and unmeasured care planning for complex members. The table below sets out each new measure with its code, the population it applies to, and its measure type.

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Code	Measure	Description	Type
COF-E	Follow-Up After Positive Colorectal Cancer Non-Invasive Screening Test	Percentage of persons ages 45 to 85 who receive a colonoscopy within 180 days of a positive non-invasive colorectal cancer screening test	New
PSY-E	Prenatal Syphilis Screening	Assesses syphilis screening during pregnancy; addresses a nearly 700% rise in congenital syphilis cases between 2015 and 2024	New
GID-E	Person-Centered Outcome — Goal Identification	Percentage of members 18 and older with a complex care need, in a D-SNP or C-SNP, who set a person-centered care goal	New
GIF-E	Person-Centered Outcome — Goal Follow-Up	Percentage of the same population who followed up on a previously set person-centered care goal	New
GIA-E	Person-Centered Outcome — Goal Achievement	Percentage of the same population who achieved a previously set person-centered care goal	New
CGD-E	Continuous Glucose Monitoring Utilization for Patients With Diabetes	Utilization measure (not a performance measure) tracking CGM use among members ages 18 to 75 with diabetes	New

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NCQA also updated three existing HEDIS measures and shifted one additional measure to ECDS reporting in the same release, continuing the format changes NCQA began with the MY 2026 technical update.

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HEDIS® MY 2027: What changed, at a glance

NCQA's HEDIS Measurement Year 2027 Volume 2 release

New measures

Screening, person-centered outcomes, and diabetes monitoring

Measures updated

Existing HEDIS measures revised for MY 2027

Moving to ECDS

Additional measure shifts to digital reporting

Under review for retirement

NCQA's public comment period on these retirements

Source: NCQA, HEDIS MY 2027 Volume 2: Technical Specifications

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Ten measures under review for retirement

NCQA is proposing to retire ten HEDIS measures for MY 2027 as part of its ongoing measure curation process. The decision is not final. NCQA is collecting public comment through August 17, 2026, ahead of a Committee on Performance Measurement review in September, and any approved retirements will be available in the March 2027 Technical Update. The ten candidates appear below with the product lines each one affects and the reason NCQA gave for proposing its retirement.

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Code	Measure	Product lines	Retirement rationale
DBM-E	Documented Assessment After Mammogram	Commercial, Medicaid, Medicare	Small, unreliable denominator
OED	Oral Evaluation, Dental Services	Medicaid	Duplicates other required measurement
TFC	Topical Fluoride for Children	Medicaid	Duplicates other required measurement
DMH	Diagnosed Mental Health Disorders	Commercial, Medicaid, Medicare	Descriptive, not actionable
DSU	Diagnosed Substance Use Disorders	Commercial, Medicaid, Medicare	Descriptive, not actionable
SMD	Diabetes Monitoring for People With Diabetes and Schizophrenia	Medicaid	Small, unreliable denominator
SMC	Cardiovascular Monitoring for People With Cardiovascular Disease and Schizophrenia	Medicaid	Small, unreliable denominator
HDO	Use of Opioids at High Dosage	Commercial, Medicaid, Medicare	Out of step with updated guidance
COU	Risk of Continued Opioid Use	Commercial, Medicaid, Medicare	Duplicates other required measurement
LDM	Language Description of Membership	Commercial, Medicaid, Medicare	Descriptive, not actionable

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The ten candidates fall into four groups:

Small, unreliable denominators (DBM-E, SMC, SMD). Too few reportable cases per plan to produce a dependable rate. NCQA is exploring a broader serious mental illness measure that could take their place.
Descriptive, not actionable (DMH, DSU, LDM). Population characteristics with no directional quality signal a plan can act on.
Duplicates other required measurement (OED, TFC, COU). OED and TFC duplicate dental measures already required through federal programs. COU overlaps Use of Opioids From Multiple Providers, which NCQA is consolidating into a single measure.
Out of step with updated guidance (HDO). The measure's opioid-dosage threshold no longer aligns with current CDC clinical practice guidelines, and NCQA sees too little plan-to-plan differentiation to justify a revision.

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NCQA is direct that retiring DMH, DSU, SMC, and SMD does not reflect reduced attention to behavioral health and substance use care. The agency describes its commitment to those areas as unchanged and frames the retirements as a search for measures that produce a clearer, more actionable signal, including a possible future measure for serious mental illness.

Health plans reporting any of these ten measures should keep collecting the underlying data in the meantime, since retirement is not guaranteed.

HEDIS MY27 changes shift toward digital, longitudinal, outcomes-based measurement

NCQA is holding steady on its timeline for retiring the HEDIS hybrid reporting method in 2029, which combines administrative claims with manual medical record review. Measures are moving away from the combination of administrative claims and manual medical record review to full-population ECDS reporting or administrative-only specifications.

Only three hybrid measurement seasons remain before the MY 2029 deadline, and NCQA has already published measure-specific timelines:

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Measurement year	Measure	New reporting method
MY 2026	Lead Screening in Children (LSC)	Administrative only
MY 2027	Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (WCC)	Administrative only
MY 2028	Prenatal and Postpartum Care (PPC)	New ECDS and risk-based replacement measure
MY 2028	Controlling High Blood Pressure (CBP); Blood Pressure Control for Patients With Diabetes (BPD)	ECDS
MY 2029	Glycemic Status Assessment for Patients With Diabetes (GSD)	ECDS

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Four hybrid measures have already shifted to ECDS: Colorectal Cancer Screening, Cervical Cancer Screening, Childhood Immunization Status, and Immunization Status for Adolescents. ECDS reporting draws on structured data from EHRs, health information exchanges, and registries, so a health plan's ability to receive and structure clinical data year-round determines its readiness for each cycle's transition. Plans receiving structured clinical data every month of the year will report MY 2029 as a routine cycle. Plans assembling it in the fourth quarter will feel the deadline.

Building a durable quality improvement strategy

By MY 2029, HEDIS performance will belong to the plans that fund clinical data acquisition the way they fund clinical programs. Health plans that already run FHIR-based processes for their digital measures are best positioned to absorb each cycle's changes as measures are added, retired, and reformatted. Health plans still leaning on manual review for every hybrid measure have three remaining measurement years before the full MY 2029 transition to prioritize longitudinal quality improvement workflows and digital retrieval methods. Five priorities carry a plan through that transition, each with what it demands operationally and where Reveleer fits.

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Priority	What it requires	How Reveleer supports it
1. Build ECDS data feeds now	Structured clinical data flowing continuously from EHRs, HIEs, and registries instead of year-end chart pulls	Automated medical record retrieval pulls clinical data continuously
2. Maintain hybrid-measure capacity through MY 2029	Continued sampling and abstraction accuracy for measures that have not yet transitioned	Clinical Quality abstraction combines AI-assisted review with manual abstraction, covering measures whether or not they've moved to ECDS
3. Track measure-level retirement and transition risk	Visibility into which reported measures are under NCQA review or scheduled for a reporting-method change each cycle	Dashboards flag which reported measures are affected by each NCQA cycle, so data investment follows the measures actually changing
4. Engage providers on evidence submission year-round	A continuous flow of supplemental clinical data from provider groups	Care Gap Manager gives provider groups a portal with refreshed care gap lists, so supplemental evidence keeps moving through the year
5. Maintain a defensible, diagnosis-level audit trail	Documentation tying every abstracted measure and submitted code to supporting clinical evidence	Retrieval and abstraction output is packaged submission-ready, with evidence traceable back to the source record

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Reveleer Quality Improvement pairs automated medical record retrieval with AI-enabled clinical quality abstraction, producing submission-ready evidence that plans deliver to their HEDIS-certified engine. Plans can add Reveleer Care Gap Manager as a year-round layer that keeps provider groups submitting supplemental evidence outside the fourth-quarter crunch, feeding the same continuous data flow ECDS reporting depends on.

HEDIS MY 2027 changes are incremental and include six new measures, three updates, one ECDS transition, and ten measures under review. Looking ahead, only three hybrid measurement years remain. Each one is an opportunity to move another measure onto structured data ahead of the year NCQA requires it. Health plans that build ECDS feeds and year-round provider engagement now arrive at MY 2029 ready to report. Talk to a Reveleer expert about what structured clinical data your HEDIS program receives today, and what full digital reporting will require of it by MY 2029.

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By MY 2029, HEDIS performance will belong to the plans that fund clinical data acquisition the way they fund clinical programs.”
_{- Natalie Schibell, MPH, VP, Product Marketing, Reveleer}

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HEDIS MY 2027 FAQs

When is the NCQA public comment period for HEDIS MY 2027 measure retirements?

The ad hoc public comment period runs from August 3 through August 17, 2026. NCQA's Committee on Performance Measurement reviews submitted comments in September 2026 before finalizing which of the ten candidate measures are retired.

What happens to HEDIS hybrid measures by 2029?

NCQA plans to retire the hybrid reporting method, which combines administrative claims with manual medical record review, by measurement year 2029. Measures shift to full-population ECDS reporting or administrative-only specifications, with fully digital HEDIS measurement targeted for measurement year 2030.

What are the new HEDIS measures for MY 2027?

HEDIS MY 2027 adds six new measures: colorectal cancer screening follow-up (COF-E), prenatal syphilis screening (PSY-E), three person-centered outcome measures for complex care members (GID-E, GIF-E, GIA-E), and continuous glucose monitoring utilization for people with diabetes (CGD-E).

About the Author

Natalie Schibell, VP, Product Marketing, Reveleer

Natalie Schibell, MPH, is the VP of Product Marketing at Reveleer with two decades across healthcare, technology, public health, and military service. She previously led Forrester's healthcare research practice and served as a US Navy Lieutenant Commander.

HEDIS MY 2027 arrives with a digital, outcomes-based mandate

Six new measures, three updates, and one ECDS transition