HEDIS Measure: Care for Older Adults (COA)

Promoting wellness and preventing disease is key to the health of our oldest members. 

The Centers for Disease Control and Prevention’s (CDC’s) Still Going Strong campaign speaks directly to adults age 65 and older and their caregivers, to raise awareness about preventable injuries, as well as simple steps to stay healthy and independent longer.

Your patients don’t have to give up the activities they enjoy as they get older.

This COA measure includes the percentage of adults 66 years old and up who have had a medication review or a functional status assessment. The medication review must be completed by a prescribing provider or clinical pharmacist.

Tips for doing medication reviews:

Do not include medication lists or medication reviews performed in an acute inpatient setting. Medication reviews must be documented in the same medical record and include one of the following:

• A medication review signed and dated in 2026 by the prescribing provider or clinical pharmacist with the medication list in the chart (the provider’s signature is considered evidence medications were reviewed).
• A medication list including medication names, or with dosages and frequency, and any over-the-counter (OTC) medications and herbal supplemental therapies.
• Notation with the date that the patient is not taking any medication.
• A medication review performed without the member present.
• A medication review with each visit.

Tips for performing functional status assessments

There should be one or more functional status assessments done during 2026 and the different steps in an assessment can happen during separate visits throughout the year. There are no provider-type requirements to complete this assessment. A qualifying functional assessment cannot be performed in an acute inpatient setting, or limited to an acute or single condition, event, or body system like the patient’s lower back.

Documentation in the patient’s medical record must include the date when it was performed and evidence of a complete functional assessment, including:

• Notation that Activities of Daily Living (ADL) were assessed. 
• Notation of Instrumental Activities of Daily Living (IADL) were assessed.
• A phone or virtual visit to check-in with the patient.