HEDIS Compliance Programs
The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool used by more than 90 percent of U.S. health plans to measure performance on important dimensions of care and service. More than 190 million people are enrolled in health plans that report quality results using HEDIS. Since 2008, HEDIS has also been available for use by medical providers and practices. Because so many health plans use HEDIS and because the measures are so specifically defined, HEDIS can be used to make comparisons among plans. To ensure that HEDIS stays current, the National Committee for Quality Assurance (NCQA) has established a process to evolve the measurement set each year through its Committee on Performance Measurement 1.
PTM provides HEDIS Compliance Certified Auditors to provide fast and accurate abstraction services to validate the MCO’s Healthcare Effectiveness Data and Information Set (HEDIS) reporting that is required of most managed care plans.
Resources
1 Healthcare Effectiveness Data and Information Set (HEDIS) – Healthy People 2030 | health.gov
Healthcare Effectiveness Data and Information Set (HEDIS)