Healthy Blue has released two updated resources to support Medicaid providers as they prepare for HEDIS® Measurement Year 2026. These tools are designed to help practices stay current with evolving measure specifications while strengthening documentation, coding accuracy, and overall quality performance for Healthy Blue Medicaid patients.
Both resources are especially useful for practices participating in Advanced Medical Home (AMH) programs, quality improvement initiatives, and value‑based arrangements where accurate HEDIS reporting and reliable data capture are essential.
HEDIS 2026 Desktop Reference Guide
The Healthy Blue HEDIS 2026 Desktop Reference Guide provides a high‑level, measure‑by‑measure overview of HEDIS quality requirements for Medicaid providers. It includes concise descriptions of each measure, eligible populations, exclusions, measurement timing, and documentation expectations. The guide is intended to serve as a quick reference for clinical and quality teams who need to understand what counts for HEDIS without navigating full technical specifications.
This resource is particularly helpful during visit workflows, chart reviews, and quality planning discussions. By summarizing key requirements across preventive care, chronic disease management, behavioral health, maternal health, and pediatric measures, the Desktop Reference Guide helps teams focus on capturing the right information at the point of care. It also reinforces how routine clinical actions—such as timely follow‑up, screenings, and assessments—contribute directly to quality scores and reporting outcomes.
Download the Healthy Blue HEDIS 2026 Desktop Reference Guide (PDF)
HEDIS 2026 Coding Booklet
The Healthy Blue HEDIS 2026 Coding Booklet is a detailed companion resource that focuses on the “how” behind HEDIS reporting. It includes diagnosis, procedure, and service codes associated with each measure, along with practical documentation tips to support accurate claims submission and data capture. The Coding Booklet helps reduce gaps between care delivered and care reported—an essential step for reliable HEDIS performance.
This resource is especially valuable for billing staff, quality specialists, and clinical team members responsible for documentation accuracy. Clear coding guidance can help decrease the need for medical record reviews, reduce audit risk, and support appropriate reimbursement. For practices using electronic medical records, the Coding Booklet can also inform workflows, order sets, and reminders that improve consistency across providers and staff.
Download the Healthy Blue HEDIS 2026 Coding Booklet (PDF)
