HEDIS® (Healthcare Effectiveness Data and Information Set) is a set of performance measures developed by the National Committee for Quality Assurance (NCQA) for the managed care industry. HEDIS is used by more than 90 percent of America’s health plans to measure performance on important dimensions of care and service.
HEDIS results assist health plans with demonstrating improvement in its preventive care and quality measurements and demonstrate the provider’s commitment to quality care and improved health outcomes for the individuals they serve.
Here is information about the three HEDIS administrative measures currently reported by Alliance using paid claims for behavioral health services, medical/lab procedures, and pharmacy data. (Alliance data reports include uncertified, unaudited HEDIS measures. Performance measures are derived from HEDIS specifications, but have not been audited by an NCQA-certified HEDIS auditor.)