Quality and HEDIS

Quality care, and HEDIS measurement go hand in hand. HEDIS which stands for (Healthcare Effectiveness Data and Information Set) is a way for providers, plans and IPAs to measure the effectiveness of quality care. Many of the measures are designed to proactively provide care that is most effective for each age group or gender. While other measures allows us to monitor different disease states in a way that allows for better results in treatment.

Our Vision

Our mission and commitment to you is to not only provide the most up to date reporting to provide quality care. We want to provide you as many tools as possible to be successful at addressing any care gaps for our members.

What Is Being Measured?

HEDIS allows us to review and make sure this is happening by condensing all the measures into 3 key areas:

  1. Effectiveness of Care – Providing preventative health and following a care plan to prevent as best we can those who are sick from worsening.

  2. Risk Adjusted Utilization – Making sure those who need critical services can receive them and that anyone who can help is involved in your care if you have an acute condition.

  3. Access to Care – Ensures that everyone who needs an appointment can get one within a reasonable timeframe and that no one is being leftout.

2019 HEDIS Measures

Click on the below resources to get more detailed information about each focus measure of 2019.

How We Help

Our toolkit provides detailed information about the many tools we offer from reporting, EMR integration to member outreach, incentives and transportation. Click Here for an overview of our Toolkit or connect with our Quality team by calling us 916-407-2000 or email HEDIS@nivanophysicians.com

Physician Incentives

We offer incentives to both members and doctors for addressing quality care. Some measures like Prenatal and Post Partum Care have direct incentives tied to them while other measures are part of a pay for performance incentive. Click Here for more information.

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