HEDIS

Why it matters

NCQA (National Committee for Quality Assurance) established Healthcare Effectiveness Data and Information Set (HEDIS) as a comprehensive set of standardized performance measures to provide purchasers and consumers with the information required to compare health plan performance. HEDIS measures clinical quality and customer service, requiring standardized reporting under 5 domains of care:

1. Effectiveness of Care
2. Access/Availability of Care
3. Experience of Care
4. Utilization and Risk Adjusted Utilization
5. Health Plan Descriptive Information

6. Measures collected using Electronic clinical data Systems

HEDIS matters and impacts our ability to attract and maintain membership.
Please use the below links related to HEDIS reporting and Quality Improvement: