Health Plan Employer Data and Information Set (HEDIS®)

Sponsor

National Committee for Quality Assurance (NCQA).

Mode of Administration

NCQA collects HEDIS® data directly from managed care organizations and preferred provider organizations for multiple purposes. All HEDIS® data are maintained in a central database.

Description

HEDIS® is a set of standardized performance measures designed to assess the quality of health care and services provided by managed care plans. It is a common data collection instrument that the Centers for Medicare & Medicaid Services has adopted for its own use in monitoring plans. It was developed by the National Committee for Quality Assurance to provide purchasers and consumers with the ability to evaluate the quality of different health plans and to make their plan decisions based upon demonstrated value rather than simply on cost.

Primary Survey Content

HEDIS® is focused on eight measure areas:

Effective of care

Access/availability of care

Satisfaction with the experience of care (member satisfaction)

Health plan stability

Use of services

Health plan descriptive information

Cost of care

Informed health care choices

Population Targeted

Medicaid, Medicare, Commercial insurance. The care needs of different populations vary, and health plan systems for managing care may be quite population specific.

Demographic Data

Age, sex, race, education.

Years Collected

Since 1993.

Schedule

Annual.

Contact Information

Sponsor homepage: http://www.ncqa.org.

Data system homepage: http://web.ncqa.org/tabid/59/Default.aspx.

Surveillance, Epidemiology, and End Results Program (SEER) Indian Health Service (IHS) National Patient Information Reporting System (NPIRS)

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