HEDIS® stands for Healthcare Effectiveness Data and Information Set. It is a measurement tool used by more than 90 percent of U.S. health plans to evaluate performance in clinical quality and customer service.

Some HEDIS measures focus on prevention like flu shots, breast cancer or other screenings. Other measures focus on the care of people with on-going health problems, like members with diabetes who need blood sugar tests, eye exams, blood pressure checks and other care. Some of these measures use information from doctors’ claims; other measures use information from reviewing medical charts. HEDIS also uses information from other sources, such as the Wisconsin Immunization Registry (WIR). Many health plans use HEDIS results to guide improvements in quality of care.

Measurement Year 2017

Quartz is in the top five percent of managed care organizations in the nation for the following measures –

  • Childhood Immunization Status — 11 of 13 (DTap, IPV, MMR, Hepatitis B, VZV, Pneumococcal Conjugate, Rotavirus, Influenza, Combination 2, 3 and 10)
  • Immunizations for adolescents — 1 of 5 (Human Papillomavirus)
  • Breast cancer screening  Controlling high blood pressure
  • Statin therapy for patients with cardiovascular disease — received statin therapy
  • Comprehensive diabetes care — 2 of 7 (HbA1c Testing and HbA1c poor control)
  • Statin therapy for patients with diabetes — received statin therapy
  • Disease modifying anti-rheumatic drug therapy in rheumatoid arthritis
  • Follow-up after hospitalization for mental illness — 30-day
  • Follow-up after emergency department visit for alcohol and other drug dependence — 7-day and 30-day visits
  • Timely postpartum care

Quartz is in the top 10 percent of managed care organizations in the nation for the following measures –

  • Weight assessment / counseling for nutrition / physical activity for children / adolescents — BMI percentile
  • Childhood Immunization Status — 2 of 13 (HiB, Hepatitis A)
  • Immunizations for adolescents — 2 of 5 (Tdap and Combination 2)  Colorectal cancer screening
  • Comprehensive diabetes care — 2 of 7 (Nephropathy Monitoring and BP <140/90)
  • Follow-up care for children prescribed attention-deficit / hyperactivity disorder (ADHD) medication —initiation
  • Follow-up after hospitalization for mental illness — 7-day
  • Follow-up after emergency department visit for mental illness — 30-day
  • Avoidance of antibiotic treatment in adults with acute bronchitis
  • Timeliness of prenatal care
  • Use of first-line psychosocial care for children and adolescents on antipsychotics
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).