Healthcare Effectiveness Data and Information Set

HEDIS

operations

Updated 5/16/2026

Definition

A standardized performance measurement tool developed by NCQA used by health plans to evaluate quality of care across clinical and administrative domains. HEDIS measures are calculated using claims, pharmacy, lab, and enrollment data, and directly impact Medicare Star Ratings, Medicaid contracts, and commercial plan accreditation outcomes.

Standard Abbreviation

HEDIS

Database Usage

-- Example column naming
CREATE TABLE claims (
  clm_id VARCHAR(50),
  hedis VARCHAR(100),  -- Healthcare Effectiveness Data and Information Set (max 100 chars)
  ...
);

-- Example in SELECT
SELECT
  clm_id,
  hedis as healthcare_effectiveness_data_and_information_set
FROM claims;

Common uses in healthcare data

Healthcare data warehouse schema design and modeling
Interoperability and cross-system data exchange
ETL pipeline development and orchestration
Master data management (MDM) programs
Analytics and business intelligence reporting

Example database column name

ISO-11179 snake_case standard

-- Recommended column name
hedis

-- Example DDL
CREATE TABLE healthcare_data (
  record_id   VARCHAR(50)   NOT NULL,
  hedis        VARCHAR(100),  -- Healthcare Effectiveness Data and Information Set (max 100 chars)
  created_dt  TIMESTAMP     NOT NULL DEFAULT NOW()
);

Column names follow the ISO-11179 naming convention: lowercase, underscore-separated, using the standard abbreviation as a prefix where applicable.

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