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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 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

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.

 

Adolescent Immunizations (PDF)

 

Behavioral Health Follow-Up Opportunities (PDF)

 

Cardiovascular health (PDF)

 

Childhood Immunizations (PDF)

 

Closing gaps in care (PDF)

 

Dental care (PDF)

 

Diabetes (PDF)

 

Medical record review (PDF)

 

Prenatal and Postpartum Care (PDF)

 

Provider and member incentives for 2024 (PDF)

 

Weight Assessment and Counseling for Nutrition and Physical Activity (PDF)

 

Well-child visits (PDF)

 

Well Woman (PDF)

We host HEDIS webinars on a variety of topics throughout the year. You can attend the live webinars using the information below.

 

Attend live webinars

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

 

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

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