One of the most effective tools for driving quality improvement in healthcare over the past two decades has been the HEDIS measures developed by the National Committee for Quality Assurance (NCQA). Through these measures, CMS incentivizes health plans, which in turn reward physician groups and practices for high performance across a wide range of quality indicators.
In 2026, NCQA will introduce a new HEDIS measure for tobacco use screening and cessation intervention—a major step forward in aligning incentives to improve outcomes. For the first time, health plans, systems, and individual providers will be able to measure, benchmark, and be recognized for effective tobacco treatment.
For years, public health officials have worked to improve tobacco cessation performance, but the lack of a standardized, incentive-based metric has limited progress. This new HEDIS measure closes that gap—enabling feedback, recognition, and financial alignment that drive real change.
Although New York has reduced adult smoking to 12%, tobacco use remains a serious public health challenge. Each year, 28,200 adults in the state die from tobacco-related diseases. Smoking causes more deaths than alcohol, AIDS, car crashes, illegal drugs, murders, and suicides combined—and costs New York an estimated $30 billion annually in healthcare expenses and lost productivity.
“We have an extraordinary opportunity to help shape a win-win scenario for participants in the Healthix collaborative and their patients.”
— Dr. Edward Anselm, retired health plan medical director and advocate for systems change in tobacco treatment
Healthix data can provide insights at the provider, clinic, or facility level and allowing benchmarking across systems.
Treatment of tobacco use is just one of many quality improvement measures and public health indicators that can be tracked and improved collaboratively through Healthix.
Although New York has performed better than most other states in reducing the prevalence of cigarette smoking to 12% of adults, smoking in New York remains a major public health problem. Each year 28,200 adults die from tobacco related disease. Smoking kills more people than alcohol, AIDS, car crashes, illegal drugs, murders, and suicides combined. And there is an economic cost as well: the annual health care costs in New York directly caused by smoking are $12.07 billion and smoking-caused productivity losses in New York are estimated at $18.2 billion. Treatment of tobacco is the most direct way to continue progress in improving outcomes and controlling costs.
Unfortunately, national data shows that physicians are not providing effective treatment regularly. The National Commission for Quality Assurance (NCQA) will soon release a new HEDIS measure that will measure performance in screening and treating tobacco use. This new measure to be implemented in 2026 will allow insurers, health systems and practicing physicians to align incentives and improve overall performance.
“We have an extra-ordinary opportunity to help shape a win/win scenarios for participants in the Healthix collaborative and their patients,” says Dr. Edward Anselm, a retired health plan medical director now focused on systems change in tobacco treatment.
Healthix data can easily be organized into practice management and quality improvement tools to provide insights at the level of individual provider, clinic, and facility in a health system that can be benchmarked against other systems in the region.
Treatment of tobacco is the one of many types of quality improvement measures and public health indicators that can be shared collaboratively.
Dr. Anselm obtained his medical degree from the University of Health Sciences–The Chicago Medical School and completed an Internal Medicine Residency at Montefiore Medical Center. He has served in a variety of clinical and occupational settings including roles as Medical Director, Mount Sinai Health System, Center for Corporate Health; Corporate Medical Director/Vice President, Executive Health Group, National Health Services; Chief Medical Officer, HIP Health Plan of New York, and Chief Medical Officer FidelisCare New York. He retired from a position as Medical Director at Aetna in Florida.
Dr. Anselm continues to teach at the Mount Sinai School of Medicine where he holds the rank of Clinical Assistant Professor of Medicine. His areas of special interest are smoking cessation and tobacco control. Most recently, he has focused on reimbursement for tobacco cessation and has developed approaches to support medical practices in maximizing both outcomes and economic returns.
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