The Healthcare Effectiveness Data and Information Set (HEDIS) is a widely used set of performance measures in the healthcare industry, developed and maintained by the National Committee for Quality Assurance (NCQA) . HEDIS is used by more than 90% of U.S. health plans to measure performance on important dimensions of care and service, and more than 190 million people are enrolled in health plans that report quality results using HEDIS. HEDIS includes more than 90 measures across 6 domains of care: effectiveness of care, access/availability of care, experience of care, utilization and risk-adjusted utilization, health plan descriptive information, and measures reported using electronic clinical data systems.
HEDIS measures address a range of health issues, including asthma medication use, controlling high blood pressure, comprehensive diabetes care, breast cancer screening, chlamydia screening, antidepressant medication management, immunization status, and advising smokers to quit. The purpose of HEDIS is to verify a minimally acceptable level of care is given, and to identify opportunities for improvement. HEDIS data is tracked from year to year to measure health plan performance and provides valuable information about the patient populations served. The Centers for Medicare & Medicaid Services (CMS) uses HEDIS scores to monitor a health plan’s performance.
