Provider HEDIS Information Document

Highmark has created a Provider Information Document designed to provide an overview of the Healthcare Effectiveness Data and Information Set (HEDIS®) measures developed by National Committee for Quality Assurance (NCQA). NCQA exists to improve the quality of health care. NCQA is a private, non-profit organization dedicated to improving health care quality. 

Provider HEDIS Information Document

Why is the Provider HEDIS Information Document Important?

  • The quality measures outlined in the Provider Information Document have a significant role in the health care industry regarding closing gaps in care and decreasing the use of costly acute care through preventive services. By placing a greater focus on value-based care and quality improvement, HEDIS performance measures hold a critical place in helping providers achieve these goals. 
  • This document is a resource tool that includes best practices to assist in closing open gaps in care; it is a tool and is not to be used as a substitution to medical decision making. The Provider Information Document is categorized by measures highlighting four areas of interest:
    • Description of the Measure: Explains what is specifically being measured.
    • Exclusions: Lists reasons a patient would not be included in the population being measured.
    • Best Practices: Examples which can assist provider offices in closing open gaps based on literature searches.
    • Importance of the Measure: Explains why NCQA justifies this measure’s importance and the need to measure performance. 
  • As a provider in our network, you play a crucial role in improving the health of our members. We want to be sure we are doing all we can to support your efforts to drive improvements in quality and outcomes.

 

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

Last updated on 9/1/2021

 

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