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 also gathers HEDIS non-survey data through the Interactive Data Submission System (IDSS).
HEDIS consists of 81 measures across five domains of care. Because so many plans collect HEDIS data, and since the measures are 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 to help navigate challenges associated with HEDIS reporting including:
- Seamless data integration
- Dashboards and reports categorized by health plan, overall measures and product lines
- Benchmarking across providers, practices, organization and national figures
- Improved financial management
- Calculation of financial rewards for quality and other pay-for-performance metrics
- Support compliance with HEDIS benchmarks and internally set goals
HealthEC which submit HEDIS measures to insurance companies on behalf of our provider clients can also validate. HEDIS data for payers, eliminating up to 50% of data confirmation cost.
HealthEC supports quality improvement efforts and streamlines performance data submissions 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