Healthcare Effectiveness Data and Information Set (HEDIS)

HEDIS Measures

CMS contracted with NCQA to develop a strategy to evaluate the quality of care provided by SNPs.  NCQA established Healthcare Effectiveness Data and Information Set (HEDIS) measures specifically for SNPs.  HEDIS is a comprehensive set of standardized performance measures designed to provide purchasers and consumers with the information they need for reliable comparison of health plan performance.  HEDIS Measures relate to many significant public health issues, such as cancer, heart disease, smoking, asthma, and diabetes.  SNPs can use HEDIS performance data to identify opportunities for improvement, monitor the success of quality improvement initiatives, track improvement, and provide a set of measurement standards that allow comparison with other plans.  Data allow identification of performance gaps and establishment of realistic targets for improvement.

SNPs reported the following measures in HEDIS 2016:

  • Colorectal Cancer Screening
  • Care for Older Adults
  • Use of Spirometry Testing in the Assessment and Diagnosis of COPD
  • Pharmacotherapy Management of COPD Exacerbation
  • Controlling High Blood Pressure
  • Persistence of Beta-Blocker Treatment After a Heart Attack
  • Annual Monitoring for Patients on Persistent Medications
  • Medication Reconciliation Post-Discharge
  • Potentially Harmful Drug-Disease Interactions in the Elderly
  • Use of High-Risk Medications in the Elderly
  • Osteoporosis Management in Women Who Had a Fracture
  • Antidepressant Medication Management
  • Follow-Up After Hospitalization for Mental Illness
  • Board Certification
  • Plan All-Cause Readmissions

Please see the links below for the most recent SNP HEDIS Reports released by NCQA.

Page Last Modified:
12/01/2021 08:00 PM