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HEDIS Measures and Quality Improvement Projects

Healthcare Effectiveness Data and Information Set

The Healthcare Effectiveness Data and Information Set (HEDIS) is a set of standardized performance measures on specific aspects of care and service developed by the National Committee on Quality Assurance (NCQA). HPSM collects HEDIS data for Healthy Families, Healthy Kids, Medi-Cal, and CareAdvantage to meet program mandates and to identify areas for improvement.

You can review a table of HPSM’s Specific HEDIS Measures

HPSM Projects and Incentive Programs that support HEDIS

HEDIS Incentive Program Contact
Annual Teen Check-ups Medi-Cal P4P
For Members: 2 free movie tickets
Nicole Ford 650-616-2169
Liliana Ramirez 650-616-2170
Asthma Medication Medi-Cal P4P Nicole Ford 650-616-2169
Diabetes Screening HbA1C Medi-Cal P4P Nicole Ford 650-616-2169
Diabetes Screening LDL-C Medi-Cal P4P Nicole Ford 650-616-2169
Diabetes Screening
Nephropathy
Medi-Cal P4P Nicole Ford 650-616-2169
Diabetes Screening
Retinal eye exams
Medi-Cal P4P Nicole Ford 650-616-2169
Child Immunizations Medi-Cal P4P
Nicole Ford 650-616-2169
Child Well Visits Medi-Cal P4P
For Members: Gift Card
Nicole Ford 650-616-2169
Daisy Liu 650-616-2169
Prenatal Care Medi-Cal P4P
For Members: Gift Card
Nicole Ford 650-616-2169
Haydee Sermeno 650-616-2169
Mammography For Members: Gift Card Haydee Sermeno 650-616-2169
Cervical Cancer Screening For Members: Gift Card Haydee Sermeno 650-616-2169



National and State HEDIS Requirements

NCQA - National Committee on Quality Assurance

HEDIS and Quality Measurement

This provides information on how measures identified by NCQA apply to HPSM’s Medi-Cal program.


Medi-Cal Managed Care Division at the California Department of Health Care Services

Medi-Cal Managed Care and Quality Improvement

This provides information on the State’s evaluation activities and reports on required measures in quality, access, and timeliness.



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