HEDIS
Also known as: Healthcare Effectiveness Data and Information Set
HEDIS is a set of standardized performance measures used by more than 90 percent of US health plans to evaluate quality of care. Measures cover preventive screenings, chronic-disease management, behavioral health, access to care, and patient experience. HEDIS scores affect plan accreditation, Medicare Advantage star ratings, and Medicaid managed-care contract renewal.
Race and ethnicity stratification of HEDIS measures was added in 2022 and is being phased into reporting requirements. This change makes Black-patient outcomes a contractual quality metric for the plans serving them.
Medical Disclaimer
This glossary entry is for informational and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition.