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What Are the Healthcare Effectiveness Data and Information Set (HEDIS) Measures?
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The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool provided by the National Committee for Quality Assurance (NCQA) that measures the quality of care and service. It is used by more than 90 percent of America’s health plans and comprises 76 measures across five domains of care. The ubiquity of HEDIS creates a standard that makes it easier to compare the performance of health care plans.
The domains of care are:
•    Effectiveness of care.
•    Access/availability of care.
•    Experience of care.
•    Utilization and relative resource use.
•    Health plan descriptive information.
Many of the measures apply to commercial health care, Medicare and Medicaid, including board certification, antibiotic utilization and ambulatory care. Several measures, though, apply only to Medicare, such as physical activity for older adults, glaucoma screening in older adults, osteoporosis management in women who had a fracture, and fall-risk management.
To keep HEDIS up-to-date, every year the National Committee for Quality Assurance’s (NCQA) Committee on Performance Measurement, a group of “employers, consumers, health plans and others” re-evaluate the measures. The committee debates and collectively decides which measures should be included and later field tests help the committee decide how the factors are measured.
Employers, consultants and consumers often use HEDIS data and accreditation information to evaluate and choose a health care plan.
READ MORE ABOUT THIS TOPIC: National Committee for Quality Assurance (NCQA), HEDIS and Quality Compass.; National Committee for Quality Assurance (NCQA), “Summary Table of Measures, Product Lines and Changes.”; National Committee for Quality Assurance (NCQA), “Improving Outcomes in Asthma: Advancing Quality Using NCQA HEDIS Measures.”
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