HEDIS
Definition
HEDIS (Healthcare Effectiveness Data and Information Set) is a set of performance measures maintained by NCQA that health plans use to report on quality of care, such as screening rates and follow-up after hospital stays.
By the Candor Health team
Last reviewed
Also called Healthcare Effectiveness Data and Information Set
Who uses HEDIS?
Health plans report HEDIS results for accreditation, for state and federal programs, and for public comparison. Some HEDIS measures feed into Medicare Star Ratings.
How does provider data affect HEDIS?
Many measures depend on members getting the right care in time, for example follow-up visits. Members who can't find an available provider are less likely to get that care.
Is HEDIS about directories?
Not directly. Directory accuracy affects access, and access affects many of the outcomes HEDIS measures.