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 90 measures across six 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.

Anthem Blue Cross and Blue Shield is prepared to help when providers and their office staff need training to participate in required HEDIS evaluations. Providers can request consultations and training in the following areas:

• Information about the year’s selected HEDIS studies
• How data for those measures will be collected
• Codes associated with each measure
• Tips for smooth coordination of medical record data collection

Our Quality Improvement staff will contact the provider’s office when we need to review or copy any medical records required for quality improvement studies. Office staff must provide access to medical records for review and copying.

Related information

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