• HQM

HEDIS

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

categories including

  • 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

https://www.ncqa.org/news/ncqa-updates-quality-measures-for-hedis-2019/


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