HEDIS

HEDIS (pronounced he´-dus) stands for Healthcare Effectiveness Data and Information Set. Employers and individuals use HEDIS to measure the quality of health plans. HEDIS measures how well health plans give service and care to their members.

Here's how it works: Health plans collect data about their performance on certain services and types of care. For instance, the plan keeps track of how many children get immunizations. They report the data to the National Committee for Quality Assurance (NCQA), which rates health plans based on 81 measures across five areas of care. Health plans use HEDIS to see where they are performing well, and where they need to improve. Employers and consumers can also you HEDIS measures when deciding what health plan to choose.

Plans that meet a certain HEDIS score may become "accredited."

See also NCQA.

WebMD Medical Reference Reviewed by Sarah Goodell on June 19, 2019
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