Abstract

The Health Plan Employer Data and Information Set (HEDIS)* is an evolving set of criteria for collecting data on health maintenance organizations (HMOs). Initially designed by a consortium of employers and health plan representatives, it is owned by the National Committee for Quality Assurance (NCQA) and becomes more complex each year. As of 1999, HEDIS results are being used in NCQA HMO accreditation scoring. This article describes the changes in HEDIS for 1999, some possible changes for 2000, and how a health plan can use HEDIS to its advantage when preparing to meet NCQA accreditation standards.

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