About HEDIS®
The Health Plan Employer Data and Information Set
HEDIS is a set of standardized performance measures designed to ensure
that purchasers and consumers have the information they need to reliably
compare the performance of managed health care plans. The performance
measures in HEDIS are related to many significant public health issues
such as cancer, heart disease, smoking, asthma and diabetes. HEDIS also
includes a standardized survey of consumers' experiences that evaluates
plan performance in areas such as customer service, access to care and
claims possessing. HEDIS is sponsored, supported and maintained by NCQA.
HEDIS provides purchasers and consumers with an unprecedented ability
both to evaluate the quality of different health plans along a variety
of important dimensions, and to make their plan decisions based upon demonstrated
value, rather than simply on cost.
RESOURCES
Improving Your HEDIS Rates
HEDIS rates play an important role in health care purchasing and accreditation
requirements. Improving your HEDIS rates can increase your accreditation
status and leverage your health plan's marketability. Health plans strive
to reach the highest percentile possible and may not know where or how
to allocate resources to achieve the best results.
Our consultants can help you determine which areas
of HEDIS are priorities for improvement. We facilitate your staff to
complete an evaluation of your HEDIS results and a root cause analysis
to determine where improvement is needed. We can coach your staff through
the CQI (continuous quality improvement) process and provide resources
or tools needed to develop an action plan for improvement.
