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Health Plan Employer Data and Information Set

  • In: Encyclopedia of Epidemiology
  • Edited by: Sarah Boslaugh
  • Subject:Public Health (general), Public Health Research Methods , Epidemiology & Biostatistics

The Health Plan Employer Data and Information Set (HEDIS) is a set of performance measures for managed care health insurance plans produced by the National Committee for Quality Assurance (NCQA), an independent, not-for-profit association founded in 1990. HEDIS measures were developed to facilitate comparison of the performance of managed care plans to each other and to national benchmarks. They have also been used to study trends in managed care over time.

Four types of managed care plans are included in the HEDIS measures. Health maintenance organizations (HMOs) offer a range of benefits for a set monthly fee; managed behavioral health care organizations (MBHOs) are similar to HMOs but provide care for mental health and substance abuse disorders; point of service (POS) and preferred provider organizations (PPO) ...

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