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What is HEDIS®?

HEDIS stands for Healthcare Effectiveness Data and Information Set. We use HEDIS scores to measure our performance, determine quality initiatives and provide educational programs for you and for our members. You can use HEDIS scores to monitor your patients’ health, identify developing issues and prevent further complications.

What is HEDIS used for?

The National Committee for Quality Assurance (NCQA) coordinates HEDIS testing and scorekeeping. The Centers for Medicare & Medicaid Services uses HEDIS scores to monitor a health plan’s performance. HEDIS scores are used by more than 90% of American health plans to compare how well the plan performs in areas like:

 

  • Quality of care 
  • Access to care
  • Member satisfaction with the plan and providers

2021 HEDIS rates (PDF)

HEDIS education materials

Here are some helpful links to get started with:

 

Provider training videos

 

HEDIS value-based savings provider toolkit (PDF)

 

HEDIS supplemental data submission process

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

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