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HEDIS® overview

Measuring the performance of a health plan

We are dedicated to delivering the best possible healthcare for our members. That is why we use the Healthcare Effectiveness Data and Information Set (HEDIS ), a set of standards used to measure the performance of a health plan. In other words, HEDIS is a report card for managed care plans.

HEDIS was developed by representatives from consumer groups, employers, health plans and the National Committee for Quality Assurance (NCQA). We use HEDIS to measure the following:

  • Access and availability of care
  • Cost of care
  • Effectiveness of care
  • Health plan stability
  • Member satisfaction
  • Use of services

The findings are an important resource for self-evaluation. When we compare our annual HEDIS findings with those from previous years and national standards, we can identify our strengths and highlight opportunities for improvement.

On an ongoing basis, we send surveys to our members to gather feedback about their experience with our services and providers. This information is a valuable tool we use to ensure we deliver quality healthcare.

We collect and publish HEDIS information annually so customers can follow our progress, identify trends and see our ongoing commitment to improved performance. HEDIS findings help employer and consumer groups answer the fundamental question, "What health plan provides the best value?"

Below are some of the health issues that HEDIS measures:

  • Controlling high blood pressure
  • Caring for diabetes
  • Screening for breast cancer
  • Managing asthma medication
  • Managing antidepressant medication
  • Tracking childhood and adolescent immunizations
  • Assessing childhood and adult weight

1HEDIS is a registered trademark of the National Committee for Quality Assurance.

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