Healthcare Effectiveness Data and Information Set (HEDIS)

Years Available
2001 to present
Mode of Collection
Abstraction of administrative claims data or data from other records.
The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool used by more than 90 percent of U.S. health plans to measure performance on important dimensions of care and service. More than 190 million people are enrolled in health plans that report quality results using HEDIS. Since 2008, HEDIS has also been available for use by medical providers and practices. Because so many health plans use HEDIS and because the measures are so specifically defined, HEDIS can be used to make comparisons among plans. To ensure that HEDIS stays current, the National Committee for Quality Assurance (NCQA) has established a process to evolve the measurement set each year through its Committee on Performance Measurement.
Selected Content
HEDIS measures address a range of health issues including: asthma medication use; persistence of beta-blocker treatment after a heart attack; controlling high blood pressure; comprehensive diabetes care; breast cancer screening; chlamydia screening; antidepressant medication management; immunization status; and advising smokers to quit.
Population Covered
Persons enrolled in health plans that report quality results using HEDIS.
NCQA collects HEDIS survey results directly from health plans and Preferred Provider Organizations (PPOs) through the Healthcare Organization Questionnaire and collects non-survey data through the Interactive Data Submission System. Submission formats are defined for each type of health plan (e.g., commercial, Medicare, Medicaid) and data provider group. Schedules for data submission, analysis, and health plan ratings release are available on the HEDIS website.
Response Rates and Sample Size
HEDIS is used by more than 90% of America's health plans.
HEDIS Measures and Technical Resources.