HEDIS Measures and Technical Resources

184 million people are enrolled in plans that report HEDIS results. That makes HEDIS one of health care’s most widely used performance improvement tools. HEDIS includes measures for physicians, PPOs and other organizations. Visitors to this page often check HEDIS FAQs or ask a question through MyNCQA.

HEDIS Measures

HEDIS® measures performance in health care where improvements can make a meaningful difference in people’s lives.

Effectiveness of Care

Prevention and Screening

Respiratory Conditions

Cardiovascular Conditions

Diabetes

Musculoskeletal Conditions

Behavioral Health

Medication Management and Care Coordination

Overuse/Appropriateness

Measures Collected Through the Medicare Health Outcomes Survey

Measures Collected Through the CAHPS® Health Plan Survey

HEDIS Technical Resources

HEDIS Technical Specifications include a complete list of new and updated HEDIS measures with instructions on data collection and guidelines for calculations and sampling.

HEDIS 2019

Vol. 1: Narrative

Overview of the HEDIS measurement set and how the data are used.

Vol. 2: Technical Specifications for Health Plans

HEDIS nonsurvey measures for organizations; instructions on data collection for each measure; general guidelines for calculations and sampling.

  • Order the HEDIS Volumes
  • Technical Specifications Update – Will be posted October 1, 2018
  • HAI Standard Infection Ratio (SIR) Final Table – Will be posted January 10, 2019
  • Risk Adjustment Tables – Will be posted November 2, 2018
  • Risk Adjustment Tables for the Plan All-Cause Readmission Measure for HEDIS 2020 – Will be posted November 1, 2018
  • Medication List Directory (NDC codes) – Will be posted November 1, 2018 (also used for ACO, QRS and Physician Measurement reporting)
  • HEDIS 2019 Measure Trending Determinations – Will be posted spring 2019
  • Rules for Allowable Adjustments for HEDIS Memo (pdf) – Posted July 2, 2018
  • HEDIS Electronic Clinical Data System (ECDS)

Technical Specifications for Physician Measurement

HEDIS quality and cost of care measures for physician-level measurement.

HEDIS Measures Included in the 2019 Quality Rating System (QRS)

Quality Rating System Measure Technical Specifications are unique to the issuers offering plans on the Exchange and participating in the CMS Quality Rating System (QRS).

Technical Specifications for ACO Measurement

HEDIS quality measures for Accountable Care Organizations.

Vol. 3: Specifications for Survey Measures

HEDIS survey measures and standardized surveys from the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) program.

Specifications for the CAHPS PCMH Survey

Technical specifications and standardized questionnaires for the CAHPS survey for the patent-centered medical home (PCMH).

Vol. 5: HEDIS Compliance Audit™: Standards, Policies and Procedures

The approved method for auditing the HEDIS production process, including an information systems capabilities assessment, an evaluation of compliance with HEDIS specifications and standards that Certified HEDIS Compliance Auditors must use when conducting a HEDIS audit.

Vol. 6: The Medicare Health Outcomes Survey Manual

Technical specifications for the Health Outcomes Survey (HOS).

HEDIS 2018

Vol. 1: Narrative

Overview of the HEDIS measurement set and how the data are used.

Vol. 2: Technical Specifications for Health Plans

HEDIS nonsurvey measures for organizations; instructions on data collection for each measure; general guidelines for calculations and sampling.

Technical Specifications for Physicians

HEDIS quality and cost of care measures for physician-level measurement.

HEDIS Measures Included in the 2018 Quality Rating System (QRS)

Quality Rating System Measure Technical Specifications are unique to the issuers offering plans on the Exchange and participating in the CMS Quality Rating System (QRS).

Technical Specifications for Accountable Care Organization Measurement

HEDIS quality measures for Accountable Care Organizations.

Vol. 3: Specifications for Survey Measures

HEDIS survey measures and standardized surveys from the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) program.

Specifications for the CAHPS® PCMH Survey

Technical specifications and standardized questionnaires for the CAHPS survey for the patent-centered medical home (PCMH).

Vol. 5: HEDIS Compliance Audit™: Standards, Policies and Procedures

The approved method for auditing the HEDIS production process, including an information systems capabilities assessment, an evaluation of compliance with HEDIS specifications and standards that Certified HEDIS Compliance Auditors must use when conducting a HEDIS audit.

Vol. 6: The Medicare Health Outcomes Survey Manual

Technical specifications for the Health Outcomes Survey (HOS).

HEDIS Archives

HEDIS 2017

HEDIS 2016

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

CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).

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