The short answer. NCQA still plans to remove the HEDIS hybrid method by MY 2029 and make HEDIS reporting fully digital by MY 2030. The question few budgets answer is what happens if the provider data meant to replace chart review is not ready by then. Medical record evidence still counts after hybrid ends, but as supplemental data with proof of service, across the full eligible population instead of a hybrid sample. A plan that cuts its medical record review capacity now is betting the data arrives on time.
What NCQA has actually committed to
In November 2024, NCQA proposed retiring the hybrid method measure by measure and making HEDIS reporting fully digital by MY 2030 (1). The endpoint has not moved. NCQA still says the hybrid method ends in MY 2029 (2).
The path to that endpoint has already shifted. In January 2026, NCQA revised several measure-specific pathways and interim timelines, citing realignment efforts and the need for more measure testing (2). The new ECDS versions of Transitions of Care (TRC) and Care for Older Adults (COA) slipped to MY 2028, and both keep the hybrid option until MY 2029. Weight Assessment and Counseling (WCC) is now headed for retirement in MY 2029 instead of administrative-only reporting in MY 2027.
Seven measures still allow hybrid reporting in MY 2026, each with a standard minimum required sample of 411 members: WCC, COA, Controlling High Blood Pressure (CBP), Glycemic Status Assessment (GSD), Blood Pressure Control for Patients With Diabetes (BPD), TRC, and Prenatal and Postpartum Care (PPC). Two of them carry real money in Medicare Advantage. Controlling Blood Pressure and Diabetes Care – Blood Sugar Controlled are triple-weighted intermediate outcome measures in the 2027 Star Ratings (3).
What happens to the chart when the sample goes away
Ending the hybrid method does not end medical record review. It changes the rules and the volume.
After hybrid ends, data abstracted from medical records can still close gaps as nonstandard supplemental data. Each record used that way must be backed by proof-of-service documentation from the legal health record, and the auditor checks a sample through primary source verification. Codes alone do not count; the documentation must show the service was performed. ECDS reporting follows the same proof-of-service and validation rules.
The difference is the denominator. Hybrid lets a plan review charts for a systematic sample drawn from the eligible population. The administrative method counts every member who meets the denominator criteria, and measures that leave hybrid move to administrative or ECDS reporting, neither of which uses the hybrid sample. If provider data does not arrive electronically, every open gap becomes a potential chart chase, year-round, with audit-ready documentation.
So ask the question before the budget does: if hybrid ended today, how many of your open gaps could only a chart close?
The data will not be there on time
The case for ending hybrid assumes providers can send structured clinical data to plans. Federal data says many cannot, or do not.
Small practices. In 2024, 91% of office-based physicians used a certified EHR, but only 79.9% of solo practitioners and 87.0% of physician-owned practices did (4). Those are often the practices plans already chase on paper.
Exchange, not just adoption. In 2019, 35% of office-based physicians shared patient information with outside providers only by fax, mail, or e-fax, and only 10% engaged in all four domains of interoperable exchange (5). Having an EHR is not the same as sending data to a health plan.
Behavioral health. In 2024, 25% of substance use and mental health treatment facilities used a mix of EHR and paper charts, and only 19% participated in a health information exchange. Among state government facilities, 51% still combined EHR and paper (6).
Contracts. Most provider agreements do not require timely electronic clinical data in a defined format, and federal interoperability rules push data from plans to providers, not the other way. We covered this in Your provider contracts are your HEDIS strategy.
What if the replacement isn't ready?
Many plans are building budgets around the end of hybrid. Medical record review teams are shrinking, and some vendors are deferring investment in retrieval and abstraction platforms on the assumption that the work goes away. Before you sign off on that plan, walk through three scenarios.
Hybrid ends on schedule and the data arrives. The plan that kept its abstraction team moves it to prospective supplemental data and audit support. Keeping the capability cost little.
Hybrid ends on schedule and the data does not arrive. Every gap that electronic data misses becomes a full-population chart chase for your highest-weight measures, with a smaller team, older tools, and auditors checking each nonstandard record against the legal health record.
NCQA extends hybrid for some measures. NCQA has already adjusted interim pathways once, in January 2026. A plan that dismantled its MRR program rebuilds it under deadline, with vendors that stopped investing.
Only one of those scenarios rewards cutting medical record review now. Which one is your budget assuming?
What the three-year budget looks like, with and without MRR capacity
The two paths look similar in a single budget year. They separate over three measurement years. Both assume year-round retrieval, which every plan should run whether or not hybrid ends. The difference is the capacity behind it.
Path 1: Cut medical record review now.
MY 2027. Abstraction staff and retrieval vendor scope shrink. The hybrid method is still available, so a smaller team runs year-round retrieval and a full hybrid season.
MY 2028. The savings show on the budget. The ECDS versions of TRC and COA arrive as an option, and more of the rate depends on data the plan may not receive.
MY 2029. Hybrid ends. If the data is not there, the plan faces full-population chart retrieval for CBP and GSD with a smaller team and vendors that stopped investing. Rebuilding costs land at peak demand.
Path 2: Keep the capability and shift it.
MY 2027. Core abstraction and over-read staff stay, so year-round retrieval has the people to close what it finds. Electronic data terms go into provider renewals, and maintenance and capacity terms go into vendor contracts.
MY 2028. Part of the abstraction team moves to nonstandard supplemental data and primary source verification packages. Each numerator is tracked by data source, and chart work scales to what electronic data does not close.
MY 2029. Hybrid ends. If the data arrived, staff move to data validation and provider education. If it did not, the plan scales a program that already runs instead of building one.
Path 1 saves money in the first two years. Path 2 costs more in MY 2027 and protects two triple-weighted Star Ratings measures in MY 2029. Run your own numbers: the cost of the team you keep against the Star Ratings and quality revenue riding on CBP and GSD.
How to prepare either way
Run year-round retrieval either way. Every plan should retrieve records for open gaps all year, not only during a spring hybrid sprint. Keep experienced abstractors and over-readers, and train them on proof-of-service rules for nonstandard supplemental data.
Build the record trail auditors will ask for. Standardize abstraction tools, documentation, and primary source verification packages now, so every chart-based gap closure holds up in audit.
Fix the contracts. Add electronic clinical data rights, a defined format, in-year timeliness, and record-access terms for practices still on paper.
Hold vendors to maintenance. Write platform support, roadmap, and capacity commitments through at least MY 2030 into retrieval and abstraction contracts.
Forecast both scenarios. Model Star Ratings and quality incentive revenue for CBP and GSD with and without full-population chart support. Know the cost of the chase before you cut the team.
Track where every compliant member comes from. Measure by measure, split the numerator by source: claims, standard supplemental data, nonstandard supplemental data, and hybrid charts. That split shows where the cliff is.
What to do next
Pull your MY 2025 rates for the seven hybrid measures and split each numerator by data source.
Estimate the full-population chase: open gaps in the full eligible population for CBP, GSD, and TRC that no electronic source closes today.
Pause any medical record review staffing cut until that estimate is done.
Review vendor contracts for platform maintenance and capacity through MY 2030.
Add electronic clinical data terms to the next round of provider contract renewals, starting with your highest-volume groups.
Frequently asked questions
When does NCQA end the HEDIS hybrid method? NCQA plans to remove the hybrid method by MY 2029 and make HEDIS reporting fully digital by MY 2030. In January 2026, NCQA revised several measure-specific pathways, including delaying the ECDS versions of TRC and COA to MY 2028, but kept the MY 2029 endpoint.
Can medical record data still be used after hybrid ends? Yes, as nonstandard supplemental data. It must be backed by proof-of-service documentation from the legal health record, and the auditor checks a sample through primary source verification.
Why could chart chase volume go up when hybrid ends? Hybrid lets plans review charts for a systematic sample, with a standard minimum of 411 members per measure. Administrative reporting counts every member who meets the denominator criteria, and ECDS does not use the hybrid sample, so every gap that electronic data does not close is a potential chart retrieval.
Which Star Ratings measures are most exposed? Controlling Blood Pressure and Diabetes Care – Blood Sugar Controlled are hybrid-eligible HEDIS measures and triple-weighted intermediate outcome measures in the 2027 Star Ratings. Transitions of Care and Care for Older Adults also rely on medical record data and keep the hybrid option until MY 2029.
Sources
NCQA, "NCQA's Proposed Timeline for Retiring and Replacing HEDIS Hybrid Measures," November 15, 2024. ncqa.org
NCQA, "HEDIS Electronic Clinical Data Systems (ECDS) Reporting," Hybrid Transition section, updated October 2, 2026. ncqa.org
CMS, "2027 Star Ratings Measures and Weights." cms.gov
Barker W. "Office-based Physician Electronic Health Record Adoption, 2008-2024." ONC Data Brief No. 84, June 2026. healthit.gov
Pylypchuk Y, Everson J, Charles D, Patel V. "Interoperability Among Office-Based Physicians in 2019." ONC Data Brief No. 59, July 2022. healthit.gov
Chang W, Owusu-Mensah P. "Electronic Health Record Adoption and Exchange Capabilities Among Substance Use and Mental Health Treatment Facilities, 2024." ONC Data Brief No. 82, April 2026. healthit.gov
About the author
Tina M. Dueringer, BSN, RN, CCM, PCC is CEO and Principal Advisor of Dueringer Advisors, Inc., a clinically led advisory firm for health plans and the companies that serve them. About Tina
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