Select a HEDIS measure. Identify which types of health care organizations must meet this measure, what the ramifications are for NOT achieving this measure, and how this measure might impact quality.

Effectiveness of care is a HEDIS domain measure that applies to clinics, hospitals, private care, emergency facilities, and any healthcare organization that provides services to consumers. The results of this measure are aggregated with other domains of measure and used to score the facility and this is then used to create a scoring system for the insurance plans, HMOs, and other facilities with a healthcare system. As such, a low HEDIS score can mean a loss of business for a healthcare facility or its removal from a particular healthcare network. The idea behind this measure is to provide consumers with a means of judging healthcare and this increase quality.

One of the issues with HEDIS is that it has inherent problems with measuring effectiveness of service because it has limited measures. For example, the measures are based on best practices and this is a limited number of measures and can cause results to be skewed (Neumann & Levine, 2002). Despite this drawback HEDIS appears to have a positive impact on healthcare because each year more best practices are included in the measures (Neumann & Levine, 2002).

Neumann, P. J., & Levine, B. S. (2002). Do HEDIS measures reflect cost-effective practices? Am J Prev Med, 23(4), 276-89.

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