RPM and the Push to Improve HEDIS Measures

To improve HEDIS measures, hospitals need actionable, trackable strategies tied to patient outcomes. HEDIS, Healthcare Effectiveness Data and Information Set, is a tool developed by the National Committee for Quality Assurance (NCQA) to measure the effectiveness, safety, and timeliness of care. It consists of more than 90 performance indicators across six domains, including chronic condition management, preventive care, and behavioral health..Higher HEDIS scores translate directly into stronger performance in value-based care programs, contract renewal eligibility with payers, and potential bonuses for providers participating in Medicare Advantage, Medicaid Managed Care, and commercial plans. For hospitals, this also impacts STAR ratings, CMS quality scores, and overall reimbursement levels. Ultimately, improved HEDIS measures directly affect care quality, rankings and revenue.