Neighborhood HEDIS® Results

Overview
HEDIS stands for Health Plan Effectiveness Data and Information Set.  It is a standardized set of performance measures created to provide consumers and purchasers with information to compare performance of managed health care plans.  HEDIS development and maintenance is sponsored and supported by the National Committee for Quality Assurance (NCQA) and is considered one component of accountability within the managed health care industry.  NCQA expects health plans to use annual HEDIS results in the development of their quality work plans and in the development of ongoing continuous improvement processes.

Methodology
HEDIS measures are specified for one of three data collection methodologies: administrative, hybrid or survey.  The Administrative method uses claims data to identify the denominator and numerator.  In this case, the denominator will include all eligible Medicaid members.  The Hybrid method uses both administrative and medical record data to identify the denominator and numerator.  The Hybrid denominator consists of a systematic sample of members drawn from the eligible population.  Member satisfaction is assessed through surveys.  Careful sample requirements include continuous enrollment information.  All measurement processes must pass an external audit by an NCQA-certified HEDIS auditor.

Benchmarks
NCQA requires accredited health plans to report a selected set of HEDIS performance measures to NCQA.  Favorable comparison of a plan’s HEDIS results to a benchmark will enhance the overall accreditation score from NCQA.  The benchmark used in this report is Quality Compass Medicaid Results (the 90th percentile) for selected HEDIS measures published by NCQA.  Regional thresholds have not been established due to the small number of participating plans.

HEDIS 2007 Results
Click the following link to view on-line.
HEDIS 2007 General Report

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).