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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 |
HPSM 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
For Members:
Gift Card |
Nicole Ford (650)616-2169
Daisy Liu (650)616-2156 |
| Prenatal Care |
Medi-Cal P4P
For Members:
Gift Card |
Nicole Ford (650)616-2169
Haydee Sermeno (650)616-2173 |
| Mammography |
For Members: Gift Card |
Haydee Sermeno (650)616-2173 |
| Cervical Cancer Screening |
For Members: Gift Card |
Haydee Sermeno (650)616-2173 |
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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