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2003 National Healthcare Quality Report

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Health Plan Employer Data and Information Set (HEDIS)

Sponsor

National Committee for Quality Assurance (NCQA).

Mode of Administration

NCQA collects HEDIS data directly from Managed Care Organizations and Preferred Provider Organizations for multiple purposes. All HEDIS data are maintained in a central database.

Description

HEDIS is a set of standardized performance measures designed to assess the quality of health care and services provided by managed care plans. It is a common data collection instrument that Centers for Medicare & Medicaid Services has adopted for its own use in monitoring plans. It was developed by the National Committee for Quality Assurance to provide purchasers and consumers with the ability to evaluate the quality of different health plans and to make their plan decisions based upon demonstrated value rather than simply on cost.

Primary Survey Content

HEDIS focused on eight categories for 2000:

Effective of care;

Access/availability of care;

Satisfaction with the experience of care (member satisfaction);

Cost of care;

Health plan stability;

Informed health care choices;

Use of services;

Health plan descriptive information.

Population Targeted

Medicaid, Medicare, Commercial insurance. The care needs of different populations vary, and health plan systems for managing care may be quite population specific.

Demographic Data

Age, sex, race, education.

Years Collected

Annual since 1993.

Schedule

Annual.

Contact Information

Sponsor homepage: http://web.ncqa.org.Exit Disclaimer

Data system homepage: http://web.ncqa.org/tabid/59/Default.aspx.Exit Disclaimer

Reference

User Guide, NCQA's Quality Compass file extracts, 2000, NCQA Measure the Quality of America's Health Care. (http://web.ncqa.org/tabid/59/Default.aspx).Exit Disclaimer

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