Knowledge Center

Healthcare Effectiveness Data and Information Set (HEDIS)

 The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool used to measure performance of various health plans on important dimensions of care and service. Truly speaking, HEDIS is a set of performance measures in the managed care industry, designed to allow consumers to compare health plan performance to other plans and to national or regional benchmarks. The Healthcare Effectiveness Data and Information Set (HEDIS) is developed and maintained by the National Committee for Quality Assurance (NCQA).

The Healthcare Effectiveness Data and Information Set (HEDIS) consist of 71 measures across 8 domains of care. HEDIS measures address a broad range of important health issues including:

  • 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
  • Advising Smokers to Quit

The Healthcare Effectiveness Data and Information Set (HEDIS) is not only important for consumers but insurance companies, employers, consultants and healthcare providers

make effective use of the HEDIS data. 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 are benefited from the HEDIS data (the Healthcare Effectiveness Data and Information Set) through the State of Health Care Quality report, which provides 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.

HEDIS performance measures are reviewed every year to ensure that the Healthcare Effectiveness Data Information Set (HEDIS) does not become obsolete. 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. The Healthcare Effectiveness Data Information Set (HEDIS) results are included in quality compass, an interactive, web-based comparison tool that allows users to view plan results and benchmark information. HEDIS data are useful for "evaluating current performance and setting goals. HEDIS plays a very important role in bringing about an improvement in the overall healthcare system.

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