NCQA > HEDIS & Quality Measurement

The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool used by more than 90 percent of America's health plans to measure performance on important dimensions of care and service.

HEDIS^® and Quality Compass^®
HEDIS is a tool used by more than 90 percent of America's health plans to measure performance on important dimensions of care and service.  Altogether, HEDIS consists of 75 measures across 8 domains of care. Because so many plans collect HEDIS data, and because the measures are so specifically defined, HEDIS makes it possible to compare the performance of health plans on an "apples-to-apples" basis. Health plans also use HEDIS results themselves to see where they need to focus their improvement efforts.

HEDIS measures address a broad range of important health issues. Among them are the following:           

• Asthma Medication Use
• Persistence of Beta-Blocker Treatment after a Heart Attack
• Controlling High Blood Pressure
• Comprehensive Diabetes Care
• Breast Cancer Screening
• Antidepressant Medication Management
• Childhood and Adolescent Immunization Status
• Childhood and Adult Weight/BMI Assessment

Many health plans report HEDIS data to employers or use their results to make improvements in their quality of care and service. Employers, consultants, and consumers use HEDIS data, along with accreditation information, to help them select the best health plan for their needs. To ensure the validity of HEDIS results, all data are rigorously audited by certified auditors using a process designed by NCQA.
Consumers also benefit from HEDIS data through the State of Health Care Quality report, a comprehensive look at the performance of the nation's health care system. HEDIS data also are the centerpiece of most health plan "report cards" that appear in national magazines and local newspapers.
 
To ensure that HEDIS stays current, NCQA has established a process to evolve the measurement set each year. NCQA’s Committee on Performance Measurement, a broad-based group representing employers, consumers, health plans and others, debates and decides collectively on the content of HEDIS. This group determines what HEDIS measures are included and field tests determine how it gets measured.
Included in HEDIS is the CAHPS® 4.0 survey, which measures members' satisfaction with their care in areas such as claims processing, customer service, and getting needed care quickly.
HEDIS is designed to provide purchasers and consumers with the information they need to reliably compare the performance of health care plans. HEDIS results are included in Quality Compass, an interactive, web-based comparison tool that allows users to view plan results and benchmark information.  Quality Compass users benefit from the largest database of comparative health plan performance information to conduct competitor analysis, examine quality improvement and benchmark plan performance.

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