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How well will HEDIS 3.0 address the Medicaid population?
1Wellness Plan, Detroit, MI 48202, USA.
Medical Interface
|June 6, 1996
Summary
State Medicaid agencies need standardized performance measures for managed care plans. The new Health Plan Employer Data and Information Set (HEDIS) for Medicaid may be insufficient due to rapid changes in performance measurement.
Area of Science:
- Health Services Research
- Healthcare Performance Measurement
Background:
- State Medicaid agencies require standardized methods to evaluate managed care plan performance.
- The Health Plan Employer Data and Information Set (HEDIS) for Medicaid was recently released to address this need.
Purpose of the Study:
- To evaluate the adequacy of the new HEDIS for Medicaid in meeting the performance measurement needs of state agencies.
- To identify core challenges facing HEDIS 3.0 in improving the Medicaid dataset.
Main Methods:
- Analysis of the HEDIS 3.0 framework and its applicability to Medicaid managed care.
- Review of the evolution of performance measurement in healthcare.
Main Results:
- The current HEDIS for Medicaid may be insufficient given the rapid evolution of performance measurement.
- HEDIS 3.0 faces significant challenges in enhancing the Medicaid dataset.
Conclusions:
- The newly released HEDIS for Medicaid may not fully address the standardized performance measurement needs of state agencies.
- Further development and adaptation of HEDIS are necessary to keep pace with evolving healthcare performance metrics.