Our providers are our partners in delivering quality health care to the communities we serve. To support you in this effort, we've put together the information and resources below.
How to be successful in HEDIS
What's HEDIS?
Healthcare Effectiveness Data and Information Set (HEDIS) is a performance measurement tool developed and administered by the National Committee for Quality Assurance (NCQA) and has become one of the most widely used set of performance measures in managed care.
HEDIS is the measurement tool used by health plans across the United States to evaluate their performance in terms of clinical quality and customer service. HEDIS includes more than 90 measures across 6 domains of care:
- Effectiveness of care
- Access and availability of care
- Experience of care
- Utilization and risk-adjusted utilization
- Health plan descriptive information
- Measures collected using electronic clinical data systems
HEDIS results are collected and reported separately for populations covered by Commercial, Medicaid, Medicare, and Exchange lines of business. HEDIS results are used to identify opportunities for improvement in the health care provided to your patients - our members and used to evaluate the effectiveness of existing quality programs.