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The Healthcare Effectiveness Data and Information Set (HEDIS)

What is HEDIS?

The Healthcare Effectiveness Data and Information Set (HEDIS), is a popular tool maintained and administered by NCQA to objectively measure health plan performance on important dimensions of care and services. It is one of health care’s most widely used tools, with more than 190 million people enrolled in plans that report HEDIS results.

Reporting Healthcare Effectiveness Data and Information Set (HEDIS)HEDIS measures performance in health care where improvements can make a meaningful difference in people’s lives. Health plans look to HEDIS data to make informed decisions regarding improvements surrounding their quality of care.

HEDIS is one component of NCQA’s accreditation process. The National Committee for Quality Assurance (NCQA) is an independent organization  that works to improve health care quality through the administration of evidence-based standards, measures, programs, and accreditation.

HEDIS was designed to allow consumers to compare health plan performance to other plans and to national or regional benchmarks. Although not originally intended for trending, HEDIS results are increasingly used to track year-to-year performance.

What you can expect

The 90 HEDIS measures are divided into six “domains of care”:
• Effectiveness of Care
• Access/Availability of Care
• Experience of Care
• Utilization and Relative Resource Use
• Health Plan Descriptive Information
• Measures Collected Using Electronic Clinical Data Systems

These measures help identify the opportunities for improvement, oversee the success of the quality improvement and provide a set of regulation standards.

How ReportingMD can help you excel

ReportingMD has the experience and programmatic knowledge to help you establish the reporting framework necessary to thrive in the HEDIS program.

With the proven experience of our team and the powerful Measure Calculation Engine, Total Outcomes Management (TOM™), data can be aggregated from disparate sources and consolidated into a single Clinical performance management tool.

Using TOM™, practices can gain complete operational visibility, identify patients at risk and manage critical patient care gaps.

TOM™ uses cloud-based architecture, an easy to use interface and is compatible with all EMRs. Learn why organizations rely on ReportingMD for powerful tools that help improve patient care measurement, improve quality outcomes, and maximize reimbursement and bonus – across even the most complex programs. Our experts can walk you through the process from measure selection to optimization, and reporting.