Back to School: HEDIS 101

Back to School: HEDIS 101

It’s September and that means back to school for much of the country! While this year going back to school might look a bit different with virtual learning, hybrid models, or socially distanced classes, children are still getting back into learning mode after so many months relaxing.

Isn’t now as good a time as any to get yourself back into the classroom and learn a bit more about HEDIS? Not sure what you need to know about HEDIS? How about you sit back, relax, and get a quick refresher course in all things HEDIS.

What is HEDIS and why is it important?

HEDIS stands for the Healthcare Effectiveness Data and Information Set. This is a standardized set of performance measures that were created by the National Committee for Quality Assurance (NCQA). These performance measures are used to analyze consumer health care. This tool is utilized by more than 90% of health plans in the United States to gauge their performance. For some health plans, the measures help them fulfill state and federal regulatory and accreditation requirements, as well as analyze specific areas for improvement.

What are the HEDIS domains of care?

There are several HEDIS domains of care which the various performance measures fall under. The domains of care are:

  • Effectiveness of Care
  • Access/Availability of Care
  • Experience of Care
  • Utilization and Relative Resource Use
  • Health Plan Descriptive Information

What benefit does HEDIS provide to the patient?

HEDIS provides a large benefit to patients. It allows them to take advantage of enhanced preventative care and self-managed care, as well as letting them choose their health plan based on the quality scores they receive. Overall, HEDIS allows patients to receive better care and improves the physician-patient relationship.

What benefit does HEDIS provide to the providers?

HEDIS also offers a variety of benefits to providers. With HEDIS, providers can improve their quality of care and thus enhance the health of their members.

If you need assistance with your HEDIS tasks, contact HEDIS Nurses today!

If you are struggling to keep up with HEDIS, you are not alone. With constantly changing quality measures and the wrench that COVID-19 has thrown into the schedule and normal HEDIS procedures, it is understandable that you might be having a hard time keeping up with everything. Thankfully, at HEDIS Nurses, we are here to help. Whether you need to outsource all of your HEDIS work or simply need help with chart abstractions we are here to assist. Give us a call today (877) 328-2343 to speak with a knowledgeable representative about the services that we offer.

To learn more about the reliable and quality HEDIS services that we offer, visit us on the web at HEDIS Nurses.