HEDIS Measure: Care for Older Adults (COA)

By December 31, 2025: Clinical and billing teams must implement documentation processes to capture HEDIS COA measure compliance for patients age 66+. Specifically: (1) Providers must document medication reviews signed and dated by prescribing provider or clinical pharmacist, including medication list with names, dosages, frequency, OTC medications, and herbal supplements; (2) Providers must document functional status assessments that include notation of ADL and IADL assessments with date performed; (3) Billing team should audit encounter forms and EMR templates to ensure COA documentation fields are present and compliant; (4) Front desk staff should flag patients age 66+ at check-in to remind providers of assessment requirements; (5) Do not include assessments from acute inpatient settings. Non-compliance will result in missed HEDIS quality metrics and potential financial penalties from performance-based reimbursement models. Train all clinical staff on documentation requirements by January 1, 2026.