We are pleased to introduce a new article series in Partners in
Health UpdateSM: Highlighting HEDIS®1
. This series is designed to
provide you with education and strategies to help you improve your
HEDIS® performance.
What is HEDIS®?
The Healthcare Effectiveness Data and Information Set (HEDIS®)
is a tool used by more than 90 percent of America?s health plans to
measure performance on important dimensions of care and service.
Altogether, HEDIS® consists of 81 measures across eight domains
of care. Because so many plans collect HEDIS® data, and because
the measures are so specifically defined, HEDIS® makes it
possible
to compare the performance of health plans reporting to the National
Committee for Quality Assurance (NCQA)2 on an "apples-to-apples"
basis.2
Why is HEDIS® important to physicians?
HEDIS® measures track a health plan?s and physician?s ability to
manage health outcomes. Generally, strong HEDIS® performance
reflects enhanced quality of care. With proactive population
management, physicians can monitor care ? improving quality while
reducing costs.
Stars3 Alert!
Numerous HEDIS® measures
overlap with measures for
the Centers for Medicare &
Medicaid Services (CMS)
Five-Star Quality Rating
Program. In each monthly
article, we will identify
those measures of critical
importance to both HEDIS®
and Stars with a yellow star
indicator (★ ).
Send us your feedback
If you have comments about the information you read in Highlighting
HEDIS® or you have topics you?d like to see included, email us.
Highlighting HEDIS® articles
Each month, Highlighting HEDIS® may include
the following:
- HEDIS® data: A visual display of data from a
chosen measure of focus. Selected data will
highlight key components or weaknesses for
the measure.
- Measure definitions and data
- Quick tips for quick improvements: Simple and
easy pointers and strategies that can improve HEDIS®
performance
- Coding 101: Instructions for coding
- Patient and provider education documents: Links to
educationaldocuments available online
1 The Healthcare Effectiveness Data and
Information Set (HEDIS) is an NCQA tool used by
more than 90 percent of America?s health plans to
measure performance on important dimensions
of care.
2 The National Committee for Quality Assurance
(NCQA) is the most widely recognized
accreditation program in the United States.
3 Stars is a program developed by CMS to
measure quality health care. Ratings are
published annually to help educate consumers
prior to enrollment decisions.
HEDIS is a registered trademark of the National Committee
for Quality Assurance (NCQA). Used with permission.