The Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used set of performance measures in the managed care industry. Developed by the National Committee for Quality Assurance (NCQA®), HEDIS is part of a larger system which complements the NCQA accreditation program and establishes accountability in health care as performance measurements used by the Centers for Medicare and Medicaid Service (CMS) and other third party reporting agencies. In areas of most concern to your patients, HEDIS helps compare how managed care plans perform.
HEDIS data is collected annually for members of Highmark’s various products. The HEDIS measures span several domains:
- Effectiveness of care
- Access/availability of care
- Experience of care
- Utilization and Risk Adjusted Utilization
- Health plan descriptive information
The following subset of HEDIS measures provides a comparison based on services received in the measurement year (MY) 2019 for the HEDIS reporting year (RY) 2020 as compared to the 2020 Quality Compass® national averages. For additional comparison, MY 2018 results are included.
Important Note: The source of the National Average data contained in this publication is from Quality Compass® 2020 and is used with the permission of NCQA®. Quality Compass® 2020 includes certain CAHPS® data. Any data display, analysis, interpretation, or conclusion based on these data is solely that of the authors, and NCQA specifically disclaims responsibility for any such display, analysis, interpretation, or conclusion.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
Quality Compass® is a registered trademark of the National Committee for Quality Assurance.
NCQA® is a registered trademark of the National Committee for Quality Assurance.
CAHPS®, Consumer Assessment of Healthcare Providers and Systems, is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).
Additional information related to 2020 HEDIS/CAHPS reporting requirements and Covid-19 per NCQA®: https://www.ncqa.org/covid/
Per CMS guidance, Quality Compass® 2020 Medicare products will not be reported or released.