Part 1: Closing Care Gaps to Achieve Quality Goals

In modern healthcare, quality of care is defined as patients receiving the services that their health status dictates. Determination of the specific services needed is based on clinical guidelines published by regulators and industry leadership. For decades, the National Committee for Quality Assurance (NCQA) has published the Healthcare Effectiveness Data and Information Set (HEDIS) as a tool to measure quality of care.

Part 1 of our Delivering Value Series will introduce you to Care Gaps, how to identify them and how to close them.

Article 1

What are Care Gaps?

The Healthcare Effectiveness Data and Information Set (HEDIS) is used by most commercial and all government sponsored health plans to measure performance in a value-based health care environment. The guidelines are revised every year and as of this writing are comprised of 92 measures across 6 domains of care. HEDIS scores are often used together with the Consumer Assessment of Healthcare Providers and Systems (CAHPS) and the Health Outcomes Survey (HOS) to determine quality and effecti