HEDIS, the acronym for Healthcare Effectiveness Data and Information Set, is a
registered trademark of the National Committee for Quality Assurance (NCQA).
HEDIS is a performance measurement tool for health plans.
The standard set of measures related to care and service is organized in
Effectiveness of Care.
Access/Availability of Care.
Experience of Care.
Utilization and Risk Adjusted Utilization
Plan Descriptive Information.
Measures Collected Using Electronic Clinical Data Systems
How is HEDIS data collected?
The data is collected by health plans, submitted to NCQA, and audited according
to standards set by NCQA.
The data comes from three sources:
• Administrative data – The plan’s claims database
• Hybrid data – Claims database and review of medical records*
• Survey data – Provider and member surveys
NCQA Updates Quality Measures for HEDIS® 2019