Managed Care


For All the HEDIS Hoopla, Employers Shrug Shoulders

MANAGED CARE October 1998. © MediMedia USA
News and Commentary

For All the HEDIS Hoopla, Employers Shrug Shoulders

MANAGED CARE October 1998. ©1998 Stezzi Communications

Just a week before the National Committee for Quality Assurance released 1997 HEDIS data, a Commonwealth Fund study burst the buildup over the HEDIS release like a badly worn tire.According to the authors, only 6 percent of employers of 200 or more workers use HEDIS (Health Plan Employer Data and Information Set) information to select managed care plans. Only 9 percent require NCQA accreditation.

Not that the authors wrote off HEDIS and NCQA accreditation as irrelevant. Rather, they excoriated employers for demanding quality but then not rewarding plans that try to demonstrate a commitment to it — saying that the managed care backlash "may be directed at the wrong player."

For their part, purchasing coalitions are doing all they can to spread the word this month, a time when many large companies are right in the middle of open enrollment. The Pacific Business Group on Health, for instance, is displaying its health plan, hospital and physician report cards on its web site,

Meanwhile, PacifiCare is turning the quality question around. The HMO released a "quality index" that compared its largest medical groups in California on 12 measures of care and service. PacifiCare thinks the results will cause members to gravitate toward "blue ribbon" groups.


4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
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