A set of information about a managed care plan (MCP) designed to serve as a “report card” for the plan. HEDIS 2.5 has 9 quality measures, 5 measures of access and patient satisfaction, 20 measures of membership and utilization, 15 measures of finance, and 15 measures of plant management, for a total of 64 measures. It is periodically refined, and given version numbers, e.g., 2.5. Version 3.0 plans to include risk adjustment, and to be specific to certain “at-risk” populations. Also under development by Washington state’s Quality Improvement Implementation Task Force, university research centers, clinics, and the Washington State Department of Health is “Clinical Outcome Measure Amended HEDIS Strategy (COMAH)”, which intends to go beyond performance measurement and add measuremes of clinical outcomes. HEDIS was developed by the National Committee for Quality Assurance (NCQA), an independent nonprofit organization that accredits managed care organizations.
A set of benchmarks used to assess the quality of care provided to patients by managed care organizations. Included in these benchmarks are the numbers of immunizations administered by the plans and the extent of health screening tests provided by them.