Is Participation in HEDIS Data Collection Mandatory?

Is Participation in HEDIS Data Collection Mandatory?

HEDIS is short for the Healthcare Effectiveness Data and Information Set. This is a set of performance measures that are designed to assess how well a provider scores on several criteria.

Why is HEDIS important?

You might not think that HEDIS is all that important, but it is actually used to measure the quality of care and the value of preventative care programs. Through HEDIS, we can evaluate a health plan’s ability to show improvement as well as get an overall understanding of the health of the plan’s members. This enables us to identify gaps in care and affords the opportunity to develop programs to address those inadequacies. In fact, over 191 million people are enrolled in plans that report HEDIS scores.

Is participation in HEDIS mandatory?

Participation in HEDIS is often required by network providers and health plans. Any practices that fall under health plans that report HEDIS measures are typically required to participate in HEDIS data collection through that health plan. The mandate also usually applies to hospitals, skilled nursing facilities, and nursing homes.

Do I need to participate in HEDIS data collection to participate in the Affordable Care Act Health Insurance Marketplace?

Yes. Reporting HEDIS measures is required for participation in the Health Insurance Marketplace through the Affordable Care Act. You will need to participate in HEDIS data collection if your health plan participates in the Health Insurance Marketplace.

Who can assist with HEDIS work?

If you need help with HEDIS work, you are not alone. HEDIS can be complex and complicated and oftentimes health plans need assistance getting everything together. Thankfully, HEDIS Nurses is here to offer our assistance. We have been helping health plans with HEDIS work since 0 and would be happy to assist you as well.

Contact HEDIS Nurses today if you need help with your HEDIS work!

HEDIS data collection and chart abstractions are no laughing matter. Unfortunately, most network providers are required by their network to participate in HEDIS data collection and analysis. Thankfully, you are not alone in this endeavor! At HEDIS Nurses, we have over 2020 years of experience when it comes to assisting health plans with their HEDIS work. Whether you need to outsource your entire HEDIS task list or just need help with some chart abstractions, our skilled team can assist. Give us a call today at (877) 328-2343 to get started and obtain a quote for our services.

To learn more about the reliable and quality HEDIS services that we offer, visit us on the web at HEDIS Nurses.