What is HEDIS and Why Does it Really Matter?

What is HEDIS and Why Does it Really Matter?

You’ve heard all about HEDIS this and HEDIS that and chances are that any new employees will have their heads spinning when you try to lay it all out for them. If you’re looking for a quick recap of the Healthcare Effectiveness Data and Information Set, here’s a little refresher brought to your by Chart Review Nurses.

What is HEDIS?

Several years ago the NCQA created the Healthcare Effectiveness Data and Information Set or HEDIS. This is a tool that is utilized by over 90% of health plans in America to measure their performance. HEDIS is a good asset for tracking patient care and the health services that they receive and is a way to standardize across various states and other factors.

What are HEDIS Measures?

HEDIS measures are a way to make it easier to gauge the performance of patient care and service. They make it easier to compare health plans on an apples to apples basis instead of apples and oranges. They also help health plans determine specific areas to improve upon which makes health care better for everyone.

HEDIS measures are the specific criteria that health plans are judged on. There are currently 81 measures across 5 different categories that focus on varying aspects of care. These measures range on important health care issues, but some of them include:

  • the use of asthma medication
  • control of high blood pressure
  • breast cancer screening
  • diabetes care
  • childhood and adolescent immunizations
  • the management of antidepressant medication
  • beta-blocker treatment after heart attacks
  • childhood and adult weight and BMI assessment

As you can see, the HEDIS measures sprawl over a broad range of topics in order to comprehensively assess how well health plans are performing. With such a broad range of measures, you can see how health plans are functioning across the board, which is key for consumers and purchasers.

Do the HEDIS Measures Stay the Same?

No, the HEDIS measures actually change annually. The NCQA has put a committee in place that specifically looks into the performance measurements to determine if they need to be changed, updated, or new measures need to be added. Every year there is a process for determining this, which means that it is important to stay up to date on current measures.

Do You Need Help With Your HEDIS Tasks?

There’s a lot to take in when it comes to HEDIS tasks. Health plans can easily become overwhelmed by the sheer velocity of work, or the changing of performance measures. Thankfully, Chart Review Nurses is here to help! We work to connect health care plan representatives with quality nurses who are well versed in all this HEDIS. Our nurses can work in house or remotely, and can take on massive projects, or one off jobs that you may need assistance with. Call (877) 328-2343 or visit Hedis Nurses to learn more about the services we offer!