Data Sources—National Committee for Quality Assurance (NCQA)

Health Plan Employer Data and Information Set (HEDIS®)

Sponsor

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.

Description

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 for use in monitoring CMS plans. It was developed by NCQA to enable purchasers and consumers to evaluate the quality of different health plans and make their plan decisions based on demonstrated value rather than simply on cost.

Primary Survey Content

HEDIS® is focused 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

Population Targeted

Medicaid, Medicare, commercial insurance. The care needs of different populations vary, and health plan systems for managing care may be quite population specific.

Demographic Data

Age, sex, race, education.

Years Collected

Since 1993.

Schedule

Annual.

Contact Information

Sponsor home page: http://web.ncqa.org/.

Data system home page: http://web.ncqa.org/tabid/59/Default.aspx/.

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