Healthcare Effectiveness Data and Information Set (HEDIS)

Increasing oversight of managed care by government entities and health care accreditation boards brought about the necessity of guidelines and benchmarks by which the performance of managed care organizations could be measured. The Healthcare Effectiveness Data and Information Set (HEDIS) was created and is maintained by the National Committee for Quality Assurance (NCQA) for the purpose of developing reporting standards that can be used by various audiences to compare the performance of health plans on a standard set of measures that are continuously refined and redefined each year. What HEDIS brought to the managed care industry was a competitive market that not only is focused on competitive pricing but also has competed in the area of quality of service provision and coverage, making HEDIS reporting ...