How does HEDIS affect quality improvement strategies in an HMO?
To meet the demands of the marketplace, health plans devote considerable resources to comply with Health Plan Employer Data and Information Set (HEDIS) reporting standards and to improve performance along those measures. Given HEDIS's growing prominence, one might question whether it plays a major role in the formulation of an HMO's quality improvement strategies. The experience at NYLCare Health Plans, Inc., suggests that quality improvement strategies should focus on strengthening the ability of HMOs to meet the more general agenda of quality measurement and improvement, and not just requirements specific to HEDIS.
Hill
J W
JW
NYLCare Health Plans, New York City, USA.
Spoeri
R K
RK
D006264:Health Benefit Plans, Employee / Q000592:standards*; D019981:Health Care Sector; D006279:Health Maintenance Organizations / Q000592:standards*; D007255:Information Services; D007256:Information Systems; D008330:Management Audit; D009518:New York; D010818:Practice Patterns, Physicians'; D015397:Program Evaluation; D017749:Total Quality Management