HEDIS

is one of the most widely used sets of performance measures in healthcare, developed by the National Committee for Quality Assurance (NCQA) to evaluate the quality of care patients receive. MCM ACO’s HEDIS program helps providers not just track these measures, but actively improve them, turning quality reporting into a driver of better patient outcomes.

HEDIS measures span a broad range of care domains, preventive screenings, chronic disease management, medication adherence, behavioral health follow-up, and access to care, among others. Because these measures are tied to quality scores, star ratings, and increasingly to reimbursement, strong HEDIS performance matters both clinically and financially. Our team helps providers understand exactly which measures apply to their patient population and what’s required to satisfy each one.

At the core of our HEDIS program is care gap identification. Using clinical and claims data, we identify which patients are missing a required screening, overdue for a follow-up visit, or lacking documentation needed to satisfy a specific measure, then work with practices to close those gaps before the reporting period ends. This might mean patient outreach for an overdue mammogram, coordinating a diabetic eye exam, or ensuring a behavioral health follow-up appointment happens on schedule.