Background

The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool used by more than 90% of America's health plans to measure performance on important dimensions of care and service. The National Committee for Quality Assurance (NCQA) collects HEDIS survey results directly from health plans and Preferred Provider Organizations (PPOs) through the Healthcare Organization Questionnaire (HOQ), and collects HEDIS non-survey data through the Interactive Data Submission System (IDSS).

HEDIS consists of 81 measures across 5 domains of care. Because so many plans collect HEDIS data, and because the measures are so specifically defined, HEDIS makes it possible to compare the performance of health plans on an "apples-to-apples" basis.

Succeeding with HealthEC

HealthEC provides a robust solution with the following features to help navigate the common-place hurdles and challenges of HEDIS reporting:

  • Seamless data integration across the healthcare continuum, regardless of the source and format
  • Dashboards and reports categorized by health plan, overall measures and product lines
  • Benchmarking across providers, practices, the organization and national figures
  • Improved management of existing financial status
  • Calculation of financial rewards for quality and other Pay-for-Performance (P4P) metrics
  • Support for compliance with HEDIS benchmarks and internally set goals

HealthEC is able to submit HEDIS measures on behalf of our clients to insurance companies. HEDIS measures can also be validated for payers, thereby eliminating up to 50% of the cost of these data confirmation efforts.

HealthEC supports quality improvement efforts and streamlines submission of performance data for payers and providers by:

  • Standardizing and normalizing data from all electronic sources
  • Providing physician dashboards with drill-down capabilities to highlight and help resolve variances in care
  • Supporting resolution of gaps in care
  • Ensuring provider data submission that complies with the annual changes in measurement sets
  • Validating data on behalf of payers

Talk to us about how we can help you understand and
improve your HEDIS measures.

Contact Us About HEDIS