Definition
HEDIS (Healthcare Effectiveness Data and Information Set) is the set of standardized performance measures, maintained by the National Committee for Quality Assurance (NCQA), that health plans use to report on care quality.
HEDIS includes more than 90 measures across domains such as effectiveness of care, access and availability of care, and utilization, covering activities like preventive screenings, chronic condition management, medication adherence, and follow-up after hospitalization or emergency visits. Because measures are standardized, plans are compared on them by employers, regulators, and accreditation programs, and many HEDIS measures feed Medicare Star Ratings.
Many HEDIS gaps are, at root, outreach gaps: a member who never schedules a screening or follow-up visit. That makes reliable patient contact, through reminders, care-gap campaigns, and post-discharge calls, one of the practical levers plans have on their scores.
How Consig handles it
For health plans, Consig's automated outreach is aimed at enabling preventive care, closing care gaps, and lifting the measures that drive reimbursement, including HEDIS and Star Ratings, without increasing headcount.