Healthcare Effectiveness Data and Information Set (HEDIS®)
National Committee for Quality Assurance (NCQA).
Mode of Administration
NCQA collects HEDIS® data directly from managed care organizations and preferred provider organizations for multiple purposes. All HEDIS® data are maintained in a central database.
HEDIS® is a set of standardized performance measures designed to assess the quality of health care and services provided by managed care plans. It is a common data collection instrument that has been adopted by the Centers for Medicare & Medicaid Services (CMS) for use in monitoring CMS plans. NCQA developed HEDIS to enable purchasers and consumers to evaluate the quality of different health plans and to make plan decisions based on demonstrated value rather than simply on cost.
Primary Survey Content
HEDIS® focuses on eight measure areas:
- Effectiveness of care
- Access/availability of care
- Satisfaction with the experience of care (member satisfaction)
- Health plan stability
- Use of services
- Health plan descriptive information
- Cost of care
- Informed health care choices
Medicaid, Medicare, commercial insurance. The care needs of different populations vary, and health plan systems for managing care may be quite population specific.
Age, gender, race, education.