HEDIS (Healthcare Effectiveness Data and Information Set)

Complete Definition

HEDIS (Healthcare Effectiveness Data and Information Set) is a tool used by more than 90% of America's health plans to measure performance on important dimensions of care and service. Developed by NCQA (National Committee for Quality Assurance), HEDIS includes over 90 measures across six domains of care including Effectiveness of Care, Access/Availability of Care, Experience of Care, Utilization, Health Plan Descriptive Information, and Measures Collected Using Electronic Clinical Data Systems. Health plans use HEDIS measures for STAR ratings, accreditation, and quality improvement. Health Cloud tracks HEDIS measure compliance at the member level and automates care gap closure campaigns.

Key Points

• 1Standardized healthcare quality measures
• 2Used by 90%+ of U.S. health plans
• 3Developed by NCQA
• 4Includes 90+ measures across 6 domains
• 5Drives STAR ratings for Medicare Advantage

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