HEDIS could be considered to be a set of uniform perfection health care strategies, exclusively structured to make sure those clients and customers of health care delivery systems are able to compare the performance of managed care organizations with preferred provider organizations. “It also serves as a model for emerging systems of performance measurement in other areas of health care delivery.” (Hedis overview, 2009, p.4).
It is seen that HEDIS is seen in terms of decreasing clients’ medical costs and enhancing medical service and upliftment of quality medical services from medical health care professionals. It could also be seen reducing stay in hospitals through efficacious health care delivery systems and highest standards of care.
The role that NCQA plays in various health care responsibilities could be seen in terms of the fact that it is utilized to provide invaluable information to consumers and users of managed health care services. The newest version of HEDIS Version 3 has been specially created by NCQA’s commercial users’ performance measurements and inculcates the factual information critical to both private and public health care.
While implementing HEDIS 3.0. the facilitators have increased the quantitative benchmarks of standard measurement to seventy five, which assesses both the quality and quantitative aspects in major areas of public and private health care accountability. (Bobette, 1997).
Coming to the matter of data quality management (DQM) vis-à-vis effective management of quality needs, the following parameters needs to be re-established:
- Clinical evidences: Robustness of evidences as an accurate and sound measurement of data assessment.
- Degree of reliability of representation – The evidence documenting the facts needs to be capable of being connected with same setting and found reliable
- Degree of reliability – The data should be logically sequentialized and well organized
- Definite repeatability – in case repeat data assessments are made, all results should produce same results, confirming fidelity of data and its evidential basis
- Similarity checks – Correctness needs to be maintained even if different checks are made using discrete data sources. (Desirable attributes of HEDIS, 2009).
The following statistics for each of the current three medical conditions are provided:
In the recent years, HEDIS is commonly used by large employers to assess health parameters and compliances Again, it is seen that health care administration has mandatorily required Medicare to subject itself to HEDIS compliance in terms of health measures. This has created new responsibilities for computer generated laboratory data management as this could be vital in disease management and health restoration in patients. This could also harmonize with administrative data, or substitute for administrative data in cases where it is unavailable.
It is widely believed that NCQA is empowered to issue licenses to conduct HEDIS compliance audits. Persons who wish to take up Certificate Examinations must be working or contracted with NCQA affiliated agency. Again, the quality of audit work and other standards are constantly monitored by licensed agencies.
HEDIS believes in “value based purchasing which in turn would allow health plans to compete based on quality and value, rather than on cost.” (HEDIS compliance audit program, 2009). The American health systems has many areas that need to be substantively improved, especially in the public health care systems where financial constraints and administrative bottlenecks may not meet quality health care standards for indigent clients. It is widely believed that National Committee Quality Assurance, specifically HEDIS could go a long way in ensuring quality , reliable and safe health care services to all clients and patients and enforce due medical services performance on providers and health care specialist, whether in private or public settings.
References
Desirable attributes of HEDIS. (2009). NCQA: Measuring Quality Improving Health Care. Web.
Gustafson, Bobette. M. (1997). Evaluating patient financial services in the managed care environment. BNET: The Go To Place For Management. Web.
Hedis overview. (2009). National Committee for Quality Comment. 4. Web.
Hedis compliance audit program. (2009). NCQA: Measuring Quality Improving Health Care. Web.
Hedis 2010 public comment overview. (2009). National Committee for Quality Comment. Web.
Other measurement activities. (2008). NCQA: Measuring Quality Improving Health Care. Web.