HEDIS & Quality Measurement
HEDIS & Quality Measurement
HEDIS® (The Healthcare Effectiveness Data and Information Set) is the gold standard in health care performance measurement, used by more than 90 percent of the nation's health plans and many leading employers and regulators. HEDIS is a set of standardized measures that specifies how organizations collect, audit and report performance information across the most pressing clinical areas, as well as important dimensions of customer satisfaction and patient experience. Explore our HEDIS volume publications and products below:
Measurement Year Titling
Effective in calendar year 2020, NCQA has updated the naming convention of certain HEDIS publications to refer to the measurement year (MY) . The Volume 1 and 2 publications released in calendar year 2020 cover two measurement years: MY 2020 and MY 2021. Read more about the HEDIS schedule change here.
HEDIS Volume 1: Narrative
HEDIS Volume 1 is an indispensable reference that will help you understand the science of health care quality measurement. The Narrative gives a background on what is in HEDIS and an explanation of why the measures are important to consumers, purchasers and health plans. The Narrative also features user-friendly descriptions of each performance measure, plus valuable guidance on interpreting and using HEDIS data.
HEDIS Volume 2: Technical Specifications for Health Plans
A required resource for anyone involved in collecting, calculating or submitting HEDIS data, HEDIS Volume 2 features the complete technical specifications for each measure. It also includes general guidelines for data collection and reporting, detailed instructions about how to perform the necessary calculations and guidelines for sampling.
HEDIS is the gold standard in health care performance measurement, used by more than 90 percent of the nation's health plans and many leading employers and regulators. HEDIS is a set of standardized measures that specifies how organizations collect, audit and report performance information across the most pressing clinical areas, as well as important dimensions of customer satisfaction and patient experience.
HEDIS Digital Measure Bundles
Digital Measures are digitalized versions of existing HEDIS Volume 2 measures—the kind of measures that plans have used and reported to NCQA since the early 1990’s. They use traditional reporting methods, are machine-readable (i.e., written as computer code and are downloaded directly from our Store.
Advantages of digital measures include:
- Easier transfer of measures into your IT system. For years, people who work for health plans have bought human-readable, narrative descriptions of HEDIS measures, and then retyped into their IT systems what they understand those measures mean and intend. Machine-to-machine communication of digital measures means measures get into your computer systems quicker and easier—the right way, how the measure authors intended.
- Less interpretation, recoding and human error. When NCQA writes measures as computer code, people who work for health plans are freed to improve quality. Being freed from interpreting and retyping measure specifications reduces the chance of human error.
- Harmonization with industry standards. Our digital measures follow industry standards so HEDIS is easier to implement across the continuum of care.This consistency and standardization means providers can measure themselves using the same clinical constructs that they do when they report HEDIS results to health plans.
- Digitalized versions of existing measures are an important part of our strategy to make it easier for health plans and others to measure quality.
HEDIS Volume 3: Specifications for Survey Measures
HEDIS Volume 3 contains complete instructions for administering all the survey-based HEDIS Measures, including surveys from the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) program. Specifically, it includes the CAHPS Health Plan Survey, 5.0H Adult Version, CAHPS Health Plan Survey 5.0H Child Version, Medical Assistance with Smoking and Tobacco Use Cessation, Flu Vaccinations for Adults Ages 18-64, Flu Vaccinations for Adults Ages 65 and Older, Pneumococcal Vaccination Status for Older Adults, and Aspirin Use and Discussion. Volume 3 also includes technical specifications, background information, protocols necessary for administering the survey instruments and accompanying correspondence.
HEDIS Volume 5: HEDIS Compliance Audit™: Standards, Policies and Procedures
Health plans must submit audited HEDIS data to achieve NCQA Accreditation and/or meet employer expectations. HEDIS Volume 5 describes in detail the methodology used for auditing a health plan’s data collection programs, calculation processes and HEDIS measure results. This Volume also includes the standards and guidelines for assessing a health plan’s information systems capabilities, and the standards and guidelines used to evaluate a plan’s ability to comply with HEDIS specifications.
HEDIS Volume 6: Specifications for The Medicare Health Outcomes Survey
The Medicare Health Outcomes Survey (HOS) measure was developed to monitor and evaluate the quality of care and service provided to Medicare beneficiaries and grant them information that supports plan-to-plan comparison. HEDIS Volume 6 features details about the measure, the survey instrument and information that health plans and vendors need to report results.
HEDIS Technical Specifications for Long-Term Services and Supports Measurement
HEDIS Technical Specifications for Long-Term Services and Supports Measures is a set of Healthcare Effectiveness and Data Information Set (HEDIS®) measures designed to assess whether organizations providing or coordinating long-term services and supports (LTSS) are delivering high-quality, person-centered care. The set of four measures evaluates quality of assessment, care planning and care coordination for organizations providing LTSS. This measure set will facilitate the creation of performance standards, allow for comparison of LTSS quality across programs, and establish national benchmarks.
Technical Specifications for ACO Measurement
A necessary resource for anyone involved in collecting, calculating or submitting HEDIS data for Accountable Care Organizations (ACOs). This publication features general guidelines for data collection and the complete technical specifications for the performance measures referenced in NCQA's Standards and Guidelines for the Accreditation of Accountable Care Organizations. The publication includes detailed instructions on sampling, how to perform the necessary calculations, and all relevant data elements for reporting ACO measure results for accreditation or quality improvement initiatives.
Quality Rating System (QRS) HEDIS Value Set Directory
This Value Set Directories (VSD) product includes value sets and codes needed to calculate and report HEDIS measures included in the Quality Rating System (QRS).