Healthcare Effectiveness Data and Information Set - Structure

Structure

The 76 HEDIS measures are divided into five "domains of care":

• Effectiveness of Care
• Access/Availability of Care
• Experience of Care
• Utilization and Relative Resource Use
• Health Plan Descriptive Information

Measures are added, deleted, and revised annually. For example, a measure for the length of stay after giving birth was deleted after legislation mandating minimum length of stay rendered this measure nearly useless. Increased attention to medical care for seniors prompted the addition of measures related to glaucoma screening and osteoporosis treatment for older adults. Other health care concerns covered by HEDIS are immunizations, cancer screenings, treatment after heart attacks, diabetes, asthma, flu shots, access to services, dental care, alcohol and drug dependence treatment, timeliness of handling phone calls, prenatal and postpartum care, mental health care, well-care or preventive visits, inpatient utilization, drug utilization, and distribution of members by age, sex, and product lines.

New measures in HEDIS 2013 are “Asthma Medication Ratio,” “Diabetes Screening for People With Schizophrenia and Bipolar Disorder Who Are Using Antipsychotic Medications,” “Diabetes Monitoring for People With Diabetes and Schizophrenia,” “Cardiovascular Monitoring for People With Cardiovascular Disease and Schizophrenia,” and “Adherence to Antipsychotic Medications for Individuals With Schizophrenia.”