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What is HEDIS®?

HEDIS stands for Healthcare Effectiveness Data and Information Set. The National Committee for Quality Assurance (NCQA) coordinates HEDIS testing and scorekeeping.


What does HEDIS measure?

HEDIS measures address a broad range of important health issues. Some of these include:           

  • Blood Pressure Control for patients with Diabetes (BPD)

  • Care for Older Adults (COA)

  • Cervical Cancer Screening (CCS) 

  • Childhood Immunization Status (CIS)

  • Colorectal Cancer Screening (COL)

  • Controlling High Blood Pressure (CBP)                      

  • Developmental Screening in the First Three Years of Life (DEV) 

  • Eye Exam for patients with Diabetes (EED)

  • Hemoglobin A1C Control for patients with Diabetes (HBD)

  • Immunizations for Adolescents (IMA)

  • Prenatal and Postpartum Care (PPC) 

  • Transitions of Care (TRC)

  • Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC)


Who uses HEDIS scores? 

Who uses HEDIS scores? 

The Centers for Medicare & Medicaid Services uses HEDIS scores to monitor a health plan’s performance. More than 90% of American health plans use HEDIS scores to compare how well the plan performs in areas like: 

  • Quality of care  

  • Access to care 

  • Member satisfaction with plans and providers 

We use HEDIS scores to measure our performance, determine quality initiatives and provide educational programs for you and our members. You can use HEDIS scores to monitor your patients’ health, identify developing issues and prevent further complications. 


HEDIS education 

See the gap closure reference guide or HEDIS webinars for more information on HEDIS measures. You can also view webinars on gaps in care and the HEDIS medical record review process.


HEDIS  is a registered trademark of the National Committee for Quality Assurance (NCQA).


Check your provider manual for answers. Or contact us