Health Plan Employer Data and Information Set (HEDIS)
A widely used set of standardized performance measures developed by the NCQA that lets purchasers and consumers compare health plans on care quality and service. Plans report HEDIS metrics annually, influencing accreditation and value-based contracting.
What is the Health Plan Employer Data and Information Set (HEDIS)?
The Health Plan Employer Data and Information Set (HEDIS) is a standardized collection of performance measures developed by the National Committee for Quality Assurance (NCQA). It allows purchasers and consumers to compare health plans on the quality of care and service they deliver.
Because the measures are defined consistently, results from one plan can be meaningfully compared with another. Plans report these metrics each year across areas such as preventive screening, chronic disease management, and access to care.
Why is HEDIS important?
HEDIS reporting influences plan accreditation, public quality ratings, and increasingly the terms of value-based contracts. Strong performance signals quality to employers and members who are choosing among plans.
Because plans must capture the underlying clinical data to report well, their performance pressures flow through to the providers in their networks. Care that supports HEDIS measures, such as completed screenings, can affect how plans evaluate and engage the facilities they contract with.
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