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 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. More than 90% of American health plans use HEDIS scores to compare how well the plan performs in areas like:

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

HEDIS education materials

Here are some helpful links to start with:

Provider training videos

HEDIS tips for primary care physicians (PDF)

HEDIS tips for pediatricians (PDF)

Other training materials

HEDIS Toolkit for Providers Measurement Year 2023: Understanding measure compliance and coding references (PDF)

Our HEDIS “News You Can Use” flyer is designed with you and your practice in mind. It includes key information related to HEDIS, such as measure requirements, coding information and best practices.

Check out some recent issues.

Appropriate opioid use (PDF)

Appropriate use of antibiotics (PDF)

Behavioral Health Follow-Up Opportunities

Breast and cervical cancer screenings (PDF)

Cardiovascular health (PDF)

Childhood Healthy Habits (PDF)

Closing gaps in care (PDF)

Dental care (PDF)

Diabetes (PDF)

Follow-up care for children prescribed ADHD medication and antidepressant medication management (PDF)

Immunizations (PDF)

Medical record review (PDF)

Medication adherence (PDF)

Prenatal and postpartum care (PDF)

Provider and member incentives for 2023 (PDF)

Telemedicine (PDF)

Well-child care (PDF)

We host HEDIS webinars on a variety of topics throughout the year. You can attend the live webinars or you can see our presentations from past webinars.

Attend live webinars

You’ll get an invitation to attend our webinars. The invite contains instructions on how to attend via Webex.

Lunch and Learn for HEDIS Medical Record Review

Tuesday, January 24th 2023 at 12:00 -12:30 (EST)

Microsoft Teams meeting

Join on your computer, mobile app or room device

Click here to join the meeting

Meeting ID: 269 900 566 419
Passcode: Zbuowy

Download Teams | Join on the web

Join with a video conferencing device

heartbeat@m.webex.com

Video Conference ID: 118 630 606 6