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What is HEDIS?
- The Health Plan Employer Data and Information Set (HEDIS)
is a measurement tool used by more than 90 percent of America's health
plans.
- It evaluates a health plan's performance for clinical quality and
customer service.
- It is sponsored, supported, and maintained by the National Committee
for Quality Assurance (NCQA)
— an independent, not-for-profit organization that evaluates and
reports on health care quality in the United States.
- It was established by large employers to create a standard set of measures
so that employers can compare health plans.
What does HEDIS measure?
- Effectiveness of care (clinical results)
- Member satisfaction
- Access and availability of care, including prenatal and postpartum
care
- Use of services
- Health plan stability
- Health plan descriptive information
What is the value of HEDIS?
- It gives individuals a reliable way to make comparable and
knowledgeable choices regarding their health care.
- It helps purchasers of health benefits make more informed decisions on
behalf of their employer and employees.
- It helps guide efforts to improve the health plan and overall health
care system.
HEDIS Compliance AuditTM
- For the sixth consecutive year, Wellmark Health Plan of Iowa
has undergone a "Full Audit" of its HEDIS results by
NCQA.
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- This compliance assures both purchasers and health plans of
fair and accurate comparisons of health plan performance.
- Only organizations that undergo a full audit are allowed to
display the audit seal.
- Alliance SelectSM results were measured in the exact same way as
Wellmark Health Plan of Iowa results but have not undergone the
audit.
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Where can I learn more about HEDIS?
- Visit NCQA's Health
Choices Web site.
- In the current NCQA
Report Card, Wellmark Health Plan of Iowa received four stars (the
highest rating available) in five of the five areas that are measured:
- Access and service
- Qualified providers
- Staying healthy
- Living with illness
- Getting better
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
The source for data contained on this Web site is Quality Compass® 2006 and is used with the permission of the National Committee for Quality Assurance (NCQA). Any analysis, interpretation, or conclusion based on these data is solely that of the authors, and NCQA specifically disclaims any responsibility for any such analysis, interpretation, or conclusion. Quality Compass® is a registered trademark of NCQA.
CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).
Wellmark Blue Cross and Blue Shield is an independent licensee of the Blue Cross and Blue Shield Association doing business in Iowa and South Dakota.
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