Healthcare Effectiveness Data and Information Set

Stethoscope and pen laying on printed HEDIS® data charts.

What Is HEDIS®?

The Healthcare Effectiveness Data and Information Set (HEDIS®) is one of health care’s most widely used performance improvement tools. 191 million people are enrolled in plans that report HEDIS® results.

KDJ Consultants offers medical record review services for  Healthcare Effectiveness Data and Information Set (HEDIS®).

HEDIS® is a tool used by more than 90 percent of America’s health plans to measure performance on important dimensions of care and service.  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. Health plans also use these results themselves to see where they need to focus their improvement efforts.

What Does Hedis® Measure?

Healthcare Effectiveness Data and Information Set address a broad range of important health issues. Among them are the following:

  • Asthma Medication Use
  • Persistence of Beta-Blocker Treatment after a Heart Attack
  • Controlling High Blood Pressure
  • Comprehensive Diabetes Care
  • Breast Cancer Screening
  • Antidepressant Medication Management
  • Childhood and Adolescent Immunization Status
  • Childhood and Adult Weight/BMI Assessment

Many health plans report HEDIS® data to employers or use their results to make improvements in their quality of care and service. Employers, consultants, and consumers use this data, along with accreditation  information, to help them select the best health plan for their needs. To ensure the validity of results, all data are rigorously audited by certified auditors using a process designed by NCQA.

Consumers also benefit from this data through the State of Healthcare Quality report, a comprehensive look at the performance of the nation’s health care system. Healthcare Effectiveness Data and Information Set information is also the centerpiece of most health plan “report  cards” that appear in national magazines and local newspapers.

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KDJ Consultants has successfully participated in Healthcare Effectiveness Data and Information Set medical record review since 1997 which has provided KDJ Registered Nurses with extensive abstraction experience in several electronic health records.

KDJ has tremendous success with MRRV.  In HEDIS MY2020, all client audits passed on the first pull.