HEDIS 2017 Measures
HEDIS 2017 is coming. HEDIS (The Healthcare Effectiveness Data and Information Set) is a set of standardized measures specifying how health care plans collect, audit and report performance information in specific clinical areas, customer satisfaction, and patient experience. HEDIS data is collected through chart reviews, medical claims and surveys as well as some self-reporting by health plans. Medicare (MCR), Medicaid (MCD) and commercial insurance plans (COMM) use HEDIS as a comparison tool between health care providers. This comparison is ultimately presented to the public as a Five Star Rating system. Incentives and prestige increase as Star scores increase. Low performing plans may find themselves in jeopardy of losing their Medicare and Medicaid contracts.
HEDIS is maintained by the National Committee for Quality Assurance (NCQA). Measures reported by survey through Health Outcome Surveys (HOS) and Consumer Assessment of Healthcare Providers and Systems (CAHPS) must be conducted by an NCQA approved survey organization. These surveys will be discussed separately in another article.
For HEDIS 2017, there are now 91 measures across 7 domains of care:
1. Effectiveness of Care
Prevention and Screening
Adolescents (WCC) - MCD, COMM