Healthcare Effectiveness Data and Information Set (HEDIS®)

What is HEDIS®?

HEDIS® is a performance measurement tool that is coordinated and administered by NCQA (National Committee for Quality Assurance) and used by the Centers for Medicare & Medicaid Services (CMS) for monitoring health plan performance. HEDIS® performance measures are utilized by more than 90 percent of American health plans to compare how well a plan performs in multiple areas including: Quality of care, Access to care, and Member satisfaction with both the health plan and its providers.

Why is HEDIS® important?

Health plans use HEDIS® results to measure performance, pinpoint quality initiatives, and deliver educational programs for members and providers. HEDIS® helps to ensure that health plans are offering quality preventive care and services to members.

Value of HEDIS® to providers

HEDIS® can help you to direct efficient and effective management of your patients’ care by allowing you to continually monitor patient health, prevent further complications, and identify additional issues that may develop.

HEDIS® providers education and helpful materials

At Aetna Better Health of Kentucky, our goal is to improve access to quality health care for our members. We provide a broad network of providers and community organizations in order to achieve improved health outcomes.