Healthcare Effectiveness Data and Information Set (HEDIS)

National Center for Interprofessional Practice and Education's picture
Submitted by National Center... on Oct 20, 2016 - 11:06am CDT

Instrument
Authors: 
National Committee for Quality Assurance (NCQA)
Overview: 

HEDIS is a tool used by more than 90 percent of America's health plans to measure performance on important dimensions of care and service. Because so many plans collect HEDIS data, and because the measures are so specifically defined, HEDIS makes it possible to compare the performance of health plans. Health plans also use HEDIS results themselves to see where they need to focus their improvement efforts.  Many health plans report HEDIS data to employers or use their results to make improvements in their quality of care and service. Employers, consultants, and consumers use HEDIS data, along with accreditation information, to help them select the best health plan for their needs. To ensure the validity of HEDIS results, all data are rigorously audited by certified auditors using a process designed by NCQA.  The HEDIS (2015 version) contained 83 separate measures in five domains.

Link to Resources
Descriptive Elements
Who is Being Assessed or Evaluated?: 
Organizations
Instrument Type: 
Self-report (e.g., survey, questionnaire, self-rating)
Source of Data: 
Other
Notes for Data Sources: 

Health care plans submit the data.

Instrument Content: 
Patient / client health status
Population health
Notes for Content: 

Five sections of the 2015 version of HEDIS can be viewed on the website.

  1. Effectiveness of care (e.g., fulfillment of best practices regarding patient assessment, screening, disease management and appropriate treatments for chronic conditions, vaccinations)
  2. Access / Availability of Care (e.g., questions concerrning access, fulfillment of annual visits, call timeliness)
  3. Experience of Care - they use the CAHPS surveys (see the [Hospital] Consumer Assessment of Providers and Systems on the Nexus Assessment and Evaluation Home Page)
  4. Utilization (e.g., relative resource usage)
  5. Health plan descriptive information
Instrument Length: 

See website for details.

Item Format: 
See website for details.
Administration: 
See website for details.
Scoring: 
See website for details.
Language: 
See website for details.
Norms: 
Yes. See website for details.
Access: 
Open access (available on this website)
Notes on Access: 

See website for access.

Psychometric Elements: Evidence of Validity
Content: 
See website for details.
Response Process: 
See website for details.
Internal Structure: 
See website for details.
Relation to Other Variables: 
See website for details.
Consequential: 
See website for details.
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