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2018 HEDIS Audit Results

The Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used set of performance measures in the managed care industry. Developed by the National Committee for Quality Assurance (NCQA®), HEDIS is part of a larger system that complements the NCQA accreditation program and establishes accountability in health care.

In areas of most concern to your patients, HEDIS helps compare how managed care plans perform.

HEDIS data are collected annually for members of Highmark’s various products. The HEDIS measures span many areas of care delivery and service: 

  • Effectiveness of care
  • Access/availability of care
  • Experience of care
  • Utilization and risk-adjusted utilization
  • Health plan descriptive information

Using this subset of HEDIS measures, the performance of services that Highmark members received in measurement year (MY) 2017 for the HEDIS reporting year (RY) 2018 is compared to the 2018 national averages. And for additional comparison, MY 2016 results are included.

Those results are now available for your review.

Important Note: The source of the National Average data contained in this publication is from Quality Compass® 2018 and is used with the permission of NCQA®. Quality Compass 2018 includes certain CAHPS® data. Any data display, analysis, interpretation, or conclusion based on these data is solely that of the authors, and NCQA specifically disclaims responsibility for any such display, analysis, interpretation, or conclusion.