HEDIS (Healthcare Effectiveness Data and Information Set)

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

As defined on the NCQA (National Committee for Quality Assurance) website

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 HEDIS results themselves to see where they need to focus their improvement efforts.

HEDIS measures 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 HEDIS data, along with accreditation  information, to help them select the best health plan for their needs. To ensure the validity of  HEDIS results, all data are rigorously audited by certified auditors using a process designed by NCQA.

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

For additional information visit http://www.ncqa.org/


KDJ Consultants has successfully participated in HEDIS medical record review since 1997 which has provided KDJ Registered Nurses with extensive abstraction experience in several electronic health records.