HEDIS Resources
Overview
This HEDIS® Resources webpage offers providers information and guidelines on HEDIS measures. Healthcare Effectiveness Data & Information Set (HEDIS) is a tool from the National Committee for Quality Assurance (NCQA) that helps health plans score how well enrollees are doing in areas like preventive care (well visits, Pap smears, mammograms, and immunizations), care of pregnant women, and treatment of chronic diseases like asthma and diabetes.
The NCQA works to improve health care quality through the administration of evidence-based standards, measures, programs, and accreditation. The NCQA manages voluntary accreditation programs, and health plans seek accreditation and measure performance through the administration and submission of the HEDIS and Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys.
HEDIS Tip Sheets
HEDIS Tip Sheets have been developed to provide an overview of the specifications and criteria for the HEDIS measures. These tip sheets should be used as a guide and do not include all measure specification details, exclusions, enrollment criteria, or codes. Final measure rates are based on the complete HEDIS technical specifications for the measure.
Compliance with these measures may reduce the need for you to send medical records later for review.
Information current as of: