Fortune 500 group endorses HEDIS
Business and government adopt HEDIS
An organization of more than 80 Fortune 500 companies the Managed Health Care Association in Washington DC has called on all employers to adopt the Health Plan Employer Data and Information Set (HEDIS) 3.0 measurement system. Members of the association say a standard system for assessing the performance of managed care plans nationwide could ensure that competition in the health care marketplace would be based on quality and not simply cost.
In addition, the U.S. Health Care Financing Administration (HCFA), announced last fall that all managed care plans serving Medicare beneficiaries will be required to submit data on those HEDIS 3.0 measures relevant to Medicare beginning in 1997.
Final technical specifications for HEDIS 3.0 a set of 71 performance measures for managed care organizations are available this month. HEDIS measures are developed by the Washington, DC-based National Committee for Quality Assurance (NCQA), an independent, nonprofit watchdog organization.
Relatively few changes have been made from the draft released in July 1996. The more substantive changes include:
• maintenance of an annual screening interval for the diabetic eye exam measure;
• change in the methodology and specifications for the flu shots for older adults measure and the health of seniors measure;
• deletion of appointment access and telephone access measures;
• movement of the asthma measure to the testing set.
The final HEDIS 3.0 also clarifies guidelines for data collection and reporting. Some highlights of those guidelines include:
• A separate HEDIS report should be produced for each state in which the health plan has a Medicaid contract.
• Medicare HMO members under the age of 65 should also be included in the plan’s Medicare HEDIS report.
• Medicaid/Medicare dual eligible members should be included in both the plans’ Medicaid and Medicare reports.
Final version of HEDIS now four volumes
The final format and presentation of HEDIS 3.0 also represent a change from earlier versions. The document is actually contained in four separate volumes. The volumes are:
• Volume I a history of HEDIS and a narrative on the development and contents of HEDIS 3.0.
• Volume II the technical specifications for collecting and reporting HEDIS 3.0 data.
• Volume III NCQA’s Annual Member Health Care Survey, the standardized member satisfaction instrument employed in HEDIS 3.0.
• Volume IV Because HEDIS 3.0 will drive health plans to invest in enhanced information systems with which to capture data and track performance, Volume IV comprises a "road map" for the development of those information systems, complete with challenges and near- and long-term milestones that would be associated with the greatest gains in performance measurement of the next 10 to 15 years.
The four volumes are available as a complete set, individually, and in different packages and can be ordered by calling NCQA’s publications center at (800) 839-6487.
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