HEDIS Is Constantly Evolving—Are You Keeping Up?

November 14, 2025 · NCQA Communications

HEDIS^® is one of the most widely used sets of health care performance measures in the U.S. Whether you’re new to health care or a seasoned professional navigating quality measurement, digital transformation or regulatory changes, understanding HEDIS is essential. That’s why NCQA recently updated HEDIS 101—a foundational course that traces the origins of HEDIS, explains how it works today and previews where it’s headed.

HEDIS Began in Partnership With Large Employers

HEDIS originated from conversations between large employers and health plans about the need to improve health care quality. It wasn’t long before they reached consensus: The nation needed a standard way to measure quality that would enable health care purchasers to compare health plans. Their solution was the Health Plan Employer Data and Information Set, later renamed “Healthcare Effectiveness Data and Information Set.”

NCQA was a new organization when it became responsible for developing and maintaining HEDIS. The first HEDIS measure set was released in 1993, and quickly became the national standard for health plan performance reporting.

HEDIS Defines Quality and Value in Health Care

HEDIS helps purchasers make “apples-to-apples” comparison of health care organizations by answering questions such as:

• How effectively are care and services delivered?
• How easy is it to access care?
• Are evidence-based health care services provided to the right person at the right time?
• Do services lead to better health outcomes?

An important—and unique—component of HEDIS is its attention to statistical details. HEDIS measures use a set of rules that can be unambiguously interpreted and consistently applied across organizations. Every organization that reports HEDIS must undergo a HEDIS Compliance Audit™—an independent, objective review of its information systems capabilities and HEDIS reporting processes to certify the accuracy of results.

Because they are a trusted source of quality data, HEDIS measures are included in value-based arrangements between health plans and providers, as well as in government quality performance programs such as the Centers for Medicare & Medicaid Services Medicare Advantage Star Ratings Program and Medicaid Core Sets. NCQA also uses HEDIS data as part of its Health Plan Ratings and makes that data available to help benchmark plan performance through its Quality Compass^® tool.

The Future of HEDIS Is Digital

HEDIS measures are evolving to be “digital first.” HEDIS digital quality measures are an important part of NCQA’s strategy to improve quality measurement and encourage the exchange of health information. In 2021, NCQA began offering HEDIS digital measures that use the Fast Healthcare Interoperability Resources (FHIR^®) standard, which enables better exchange of electronic health information, and aligns with new regulations that support interoperability. NCQA’s roadmap plans to make HEDIS fully digital by 2030.

Register for HEDIS 101 Today!

Whether you’re new to HEDIS or want to refresh your knowledge, you’ll gain new insights from our recently updated, self-guided HEDIS 101 course.

• Trace the path of HEDIS from its origins to its current role as the national standard for health care quality.
• Find out how HEDIS is evolving to meet new challenges, and why it matters for improving care.
• Learn how HEDIS measures are built, tested and updated to stay accurate and relevant.
• Understand the importance of reliable and valid measure results, and learn about the validation and certification programs that build trust in HEDIS.
• Find out how population differences and data quality can affect HEDIS results.
• Discover how health plans, providers, policymakers and communities use HEDIS to support better care and outcomes.

It only takes about an hour to complete our self-guided HEDIS 101 course. Register today and share it with your team to get up to speed on the present—and future—of HEDIS.

HEDIS^® is a registered trademark of the National Committee for Quality Assurance (NCQA).

HEDIS Compliance Audit™ is a trademark of the National Committee for Quality Assurance (NCQA).

HL7^® and FHIR^® are the registered trademarks of Health Level Seven International, and their use does not constitute endorsement by HL7.