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What is HEDIS?
HEDISR
is a set of standardized performance measures designed to give purchasers and consumers
the information they need to compare the performance of managed health care plans. Initially conceived by a consortium of health plans, large purchasers and consultants as a means of gauging the quality of employer- sponsored medical benefits, HEDIS was handed over to the National Committee for Quality Assurance (http://www.ncqa.org/) for further support, development and implementation. NCQA is a not-for-profit organization committed to evaluating and publicly reporting on the quality of managed care plans. Today, close to 250 organizations representing over 400 health plans, submit annual HEDIS data to NCQA. HEDIS captures comprehensive data and evaluates the actual results a health plan achieves, in effectiveness of care, access and availability of care, cost of care and member satisfaction. With each revision, HEDIS addresses a wider range of health care issues and becomes more "outcomes," or "results," oriented. NCQA requires that HEDIS measures are (1) relevant to purchasers and consumers, (2) scientifically sound and (3) feasible to produce at a reasonable cost and in a consistent fashion with all regard for patient confidentiality. NCQA’s standard auditing procedures, and auditor certification program, ensure that HEDIS data are comparable from plan to plan. HEDIS is now the national standard in performance measurement for health plans. HEDIS measures have a successful track record, they are widely reported, and they are specifically designed to help purchasers and consumers make reliable comparisons among health plans. Users of HEDIS data include national and local media, the Health Care Finance Administration, state governments, purchasing groups and individual employers. Health plans rely on their HEDIS results to help guide internal quality improvement efforts. HEDISR is a registered trademark of the National Committee for Quality Assurance. Email - information@nehedis.org |