The Healthcare Effectiveness Data and Information Set (HEDIS)
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. Altogether, HEDIS consists of 81 measures across five domains of care. Because so many plans collect HEDIS data, and because the measures are so specifically defined, HEDIS makes it possible to compare the performance of health plans on an “apples-to-apples” basis.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
Related Information
Documents
- HEDIS well-child and immunizations coding tips
- Electronic Clinical Data Systems coding booklet
- HEDIS ECDS Prenatal and Postpartum Care Coding Bulletin 2023
- HEDIS Desktop Reference Guide 2023
- HEDIS Coding Booklet 2023
- HEDIS prenatal and postpartum care ECDS coding bulletin 2022
- HEDIS ECDS Coding Booklet 2022
- First-Line Psychosocial Care For Children And Adolescents On Antipsychotics (APP)
- Quality Measures Desktop Reference for Medicaid Providers
- HEDIS Benchmarks and Coding Guidelines for Quality Care
- Initiation and Engagement of Alcohol and Other Drug Dependence Treatment
- Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM)
Provider Tools & Resources
- Roster Automation Standard Template
- Log In To Availity
- Launch Provider Learning Hub Now
- Learn About Availity
- Prior Authorization Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Member Eligibility & Pharmacy Overview
- Policies, Guidelines & Manuals
- Referrals
- Forms
- Training Academy
- Pharmacy Information
- Electronic Data Interchange (EDI)
- Quality of Care Form