Health Plan Employer Data and Information Set

Another external response to concerns about MCOs has been an increased interest in measuring the quality of care they deliver [35]. This interest has resulted in the development of numerous quality indicators. One example, HEDIS (Health Plan Employer Data and Information Set), is a standardized set of performance indicators used to compare health plans. Developed by the National Committee for Quality Assurance, HEDIS measures allow employers and employees to evaluate different plans. Only a small number of HEDIS indicators are related to medication use, but more drug-related indicators are likely to be added in the future. The use of quality indicators likely will increase as the measures become more refined and tested. 

The Health Plan Employer Data and Information Set (HED IS) is a health care report card created by NCQA. HEDIS standardizes health plan performance data and disseminates this information so that plans can be compared (O Malley, 1997). This allows health care purchasers and consumers to make informed choices (O Malley, 1997). HEDIS s performance domains include effectiveness of care, access and availability of care, health plan stability, use of services, cost of care, informed health care choices, satisfaction with the experience of care, and health plan descriptive information. 

Physicians are being overburdened by patient visits and the necessity to follow the Health Plan Employer Data and Information Set (HEDIS) and other practice guidelines. Pharmacists can perform chart reviews to see if patients with diabetes have received regularly scheduled test for A 1C, urinary microalbumin, lipid measurements, referral for dilated eye exams, foot assessment and foot care, and blood pressure measurements. 

Health Plan Employer Data and Information Set (HEDIS)... 

Health Plan Employer Data and Information Set (HEDIS) a core set of performance measures to assist employers and other health purchasers in understanding the value of health care purchases and evaluating health plan performance. HEDIS 2.0 is currently used and distributed by NCQA (National Committee for Quality Assurance). HEDIS 3.0 is under development. 

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