What changed in HEDIS for MY 2027

HEDIS (the Healthcare Effectiveness Data and Information Set) is NCQA's set of standardized quality measures, used by more than 90% of U.S. health plans, and it feeds the Medicare Star Ratings. For Measurement Year 2027 (MY 2027), NCQA added 6 measures, updated 3 existing measures, and introduced a voluntary Electronic Clinical Data Systems (ECDS) version of Glycemic Status Assessment. Ten measures sit in a pending-retirement column while NCQA reads the public comment it collected in August. The Volume 2 technical specifications published August 3, 2026, on the date NCQA announced in advance.

6
New HEDIS measures added for Measurement Year 2027, all ECDS-reported
10
Measures pending retirement, decision expected after the September 2026 committee review
~700%
Rise in U.S. congenital syphilis cases from 2015 to 2024, the demand behind PSY-E (NCQA)

What's new for MY 2027, measure by measure

The full list, with acronyms, to check against your own reporting plan. Every addition carries the -E suffix, NCQA's marker for ECDS-reported measures. This is the first HEDIS cycle where the entire incoming class is digital.

MeasureAcronymWhat it measures
Follow-Up After Positive Colorectal Cancer Non-Invasive Screening TestCOF-EWhether persons 45 to 75 with a positive stool-based or other non-invasive colorectal screen went on to get the colonoscopy.
Prenatal Syphilis ScreeningPSY-EWhether pregnant members were screened for syphilis within the timeframes the specification sets.
Continuous Glucose Monitoring Utilization for Patients With DiabetesCGD-ECGM use among insulin-dependent members 18 to 75 with diabetes.
Person-Centered Outcome: Goal IdentificationGID-EWhether members 18 and older with a complex care need set a person-centered outcome goal.
Person-Centered Outcome: Goal Follow-UpGIF-EWhether an established goal got a follow-up.
Person-Centered Outcome: Goal AchievementGIA-EWhether the goal was achieved.

Two of the six close loops that older measures left open. Colorectal Cancer Screening (COL) credits the screen; COF-E now asks whether a positive result actually led to the colonoscopy, which is where screening programs quietly lose people. PSY-E answers a public health trend: NCQA cites 3,941 U.S. infants born with congenital syphilis in 2024, up from 495 in 2015, a rise of roughly 700%, and syphilis in pregnancy is treatable when it is caught.

The three person-centered outcome measures are a different kind of instrument. Instead of a lab value or a claim code, they track whether a goal was set, followed up and achieved for members with complex care needs. For care management teams that is the first HEDIS credit for work they already do in longitudinal plans, and it only counts if the goal lives in structured data. CGD-E does for diabetes technology what the statin measures did for pharmacy: it turns adoption of the standard of care into a reportable rate.

The three updated measures

NCQA revised three existing measures for MY 2027, and each revision changes a denominator, so each one can move your rate without any change in the care you deliver.

  • Pharmacotherapy Management of COPD Exacerbation (PCE) moves to a person-based denominator, adds an exclusion for members with comorbid asthma, and aligns with the 2025 GOLD guidelines. NCQA gave the revised measure first-year status, which means the reworked version gets a settling-in period before results carry accountability weight.
  • Adult Immunization Status (AIS-E) expands the pneumococcal vaccination denominator to everyone 50 and older, adding a 50 to 64 stratification alongside the total. The eligible population grows, so plans whose outreach starts at 65 will see the rate dilute until the younger band catches up.
  • Emergency Department Utilization (EDU) adds the Medicaid product line for members 18 to 64. Medicaid plans pick up a new utilization measure without a single specification line changing for Medicare or commercial.

GSD gets its ECDS version, on schedule

Glycemic Status Assessment for Patients With Diabetes (GSD) gains a voluntary ECDS version (GSD-E) for MY 2027. This is the hybrid retirement timeline executing as published: the ECDS version runs alongside the hybrid version as optional for two years, then GSD goes ECDS-only by MY 2029. GSD is a triple-relevant measure, a Star Ratings input, a hybrid measure, and now an ECDS pilot, so the voluntary window is the practice period. Plans that submit the ECDS version now find their data gaps while the hybrid safety net still exists. The ECDS transition guide covers the full schedule, and our MY 2026 write-up has the measure-by-measure hybrid retirement table.

The ten measures pending retirement

NCQA lists ten measures as pending retirement for MY 2027: DBM-E, OED, TFC, DMH, DSU, SMD, SMC, HDO, COU and LDM. The ad hoc public comment window ran August 3 to August 17, 2026, NCQA's measurement committees review the results in September, and a finalized retirement would come out of Volume 2 through the March 2027 Technical Update. Six of the ten touch the Medicare product line, four are Medicaid only, and none is a Star Ratings measure. We covered the full list, the reasons behind each, and the HDO and COU overlap with the MY 2028 denied-claims notice in the retirements write-up; that page will carry the outcome when NCQA publishes it.

The smaller changes that move rates

Four cross-cutting specification changes land quietly in the MY 2027 volume, and the first one touches nearly every measure.

  • The death exclusion widened. Members who die on or before the end of the measurement period are now excluded across measures. Denominators shrink slightly, and rates that looked flat can tick up with no change in performance.
  • ECDS measures are reorganized by clinical domain. The separate ECDS domain is gone; digital measures now file under the same clinical areas as everything else. A cosmetic change in the specification, a real change for any internal reporting that grouped measures by the old structure.
  • Race and ethnicity stratification reporting was updated, continuing the build-out that added Middle Eastern or North African as a category in MY 2026.
  • Palliative care exclusion value sets were modified. If your exclusion logic hardcodes the old value sets, it is now excluding the wrong members.

What MY 2027 does and does not do to Star Ratings

Nothing here changes a Star Rating this year. New HEDIS measures do not enter the Star Ratings automatically; CMS adds measures through rulemaking, usually after a display period, and none of the six additions is in the 2027 Star Ratings measure set. None of the ten pending retirements is a Star measure either. The connection is slower and structural: GSD feeds the Star Ratings today, and its ECDS version is the rehearsal for the reporting method the Star-relevant hybrid measures will all use by MY 2029. The place to watch CMS's side of the ledger is the October Star Ratings release; our 2027 Star Ratings changes post covers what is already finalized.

What this means for quality teams

The MY 2027 class is the clearest signal NCQA has sent about where the program is going. Six additions, zero of them reportable from claims alone or from a spring chart chase. COF-E needs the screening result and the follow-up procedure linked in structured data. The person-centered outcome measures need goals recorded as data, not as free-text care plan notes. CGD-E needs device utilization visible in the record.

That makes the practical MY 2027 question an infrastructure question: which of these data elements can you see today, prospectively, across your whole population? Teams with standing clinical data feeds add six measures to a pipeline that already runs. Teams still built around retrospective abstraction have no retrospective path into any of the six.

What comes next

  • September 2026: NCQA's measurement committees review the retirement comment results.
  • Early October 2026: CMS releases the 2027 Star Ratings, the other half of the quality calendar. Our CY2027 operating calendar tracks every date on that side.
  • March 2027: the HEDIS Technical Update carries corrections and any finalized retirements out of Volume 2.
  • MY 2028: the ECDS versions of Transitions of Care and Care for Older Adults arrive, and the denied-claims exclusion comes out of 21 measures, both already on advance notice.

How Pelica helps

Most quality platforms hand a team a gap list and a dashboard. Pelica is the execution layer that works the list. The Quality & Stars copilot runs on one live member record built from claims, EHR, pharmacy, lab and ADT feeds, which is exactly the structured, prospective data the entire MY 2027 class requires. When a measure like COF-E arrives, the feed already carries the screening result and the follow-up; the copilot just starts working the new gap.

At HealthCare Partners, the largest IPA in the country, Pelica closes roughly 90% of BCS and KED gaps in-year and 70%+ of TRC gaps within 30 days, with 100% team adoption across more than 175,000 patients managed live. Those are the prospective, in-year results the ECDS era demands.

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