Healthcare Effectiveness Data and Information Set

HEDIS Resources

Doctor with notepad taking notes

What is HEDIS?

The Healthcare Effectiveness Data and Information Set (HEDIS) is a set of national quality performance measures in the healthcare industry. Created by the National Committee for Quality Assurance (NCQA), HEDIS is a tool consisting of over 80 quality measurements utilized to compare health plan quality across the nation and is a requirement to be an accredited health plan. NCQA health plan accreditation assures members that they are receiving quality care by health plans and providers. 

 For more information about HEDIS, please visit NCQA website - or reach out to our Quality Management department at PerfMeasures@TrilliumNC.org.

Provider Resources for Improving Quality

Providers are vital to helping maintain accreditation status and ensuring quality care is delivered. By educating patients on important healthcare topics such as preventative screenings and behavioral health, providers are helping influence positive HEDIS outcomes. The resources below are general guidelines for improving HEDIS outcomes:

More in this Section

Behavioral Health Screening Programs Benefit Plans | Service Definitions Clinical Practice Guidelines Developmental Centers EPSDT EHR-HIE Evidence-Based Practices NC-TOPPS Value-Based Care

HEDIS Measures Monitored by Trillium

Tip Sheets

HEDIS My Learning Campus (MLC) Trainings

The Quality Management Department in Trillium has developed the following HEDIS-related trainings to offer a more detailed look at HEDIS reporting, the importance of HEDIS, what it means, what it means to the agency and providers, and talk more about measurement-based care in general. You can locate the following trainings on the My Learning Campus website.

  • HEDIS & HealthConnex Overview for Providers
  • NC HealthConnex - Improving Digital Quality

Consumer Assessment of Healthcare Providers and Systems (CAHPS)

The CAHPS Health Plan Survey is a standardized tool used to gather information about members’ experiences with their services and health plans. There are separate surveys for children (age 17 and younger) and adults (age 18 and older). This survey is administered annually. Anyone who receives Tailored Plan, Standard Plan, Medicaid Direct, Eastern Band of Cherokee Indians (EBCI) or Foster Care NC Medicaid services during the six-month measurement period is eligible to participate in the survey in North Carolina. Please refer to the CAHPS Tip Sheet for a list of CAHPS Measures and Tips for Providers.

 

More information

For information about HEDIS, please contact the Quality Management Department at PerfMeasures@TrilliumNC.org 

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