Rady Children’s Health Network wants to ensure quality and cost-effective health care solutions for our members. Our Quality Improvement program aims to advance patient safety and care. As you know, HEDIS® is a tool that is used to measure quality of care, access to care, and Member satisfaction. You can improve your HEDIS® scores significantly by submitting accurate and complete coded claims and encounter data for each service rendered.
Why is HEDIS® important to you?
- HEDIS® data ensures that optimal healthcare and services are provided to our Members
- It helps you identify non-adherent members so you can ensure they receive needed services
- It provides information allowing you to compare and rank with other Providers
- It’s the centerpiece of your quarterly Score Cards and the basis for our incentive programs
We hope these documents below will provide you with necessary information to be successful in your practice. If you have any questions or would like to discuss your specific challenges with these measures, we’d love to hear from you. Please contact us via this form.
HEDIS® Provider Guides
2025 CHA Clinical Excellence Quick Reference Guide
HEDIS® Tool and Resource
(AMR) – Asthma Medication Ration
(CHL) – Chlamydia Screening
(CIS) – Childhood Immunizations
(IMA) – Immunizations for Adolescents
(LSC) – Lead Screening
(WCC) – Weight Assessment and Counseling for Nutrition and Physical Activity
(W30) – Well Visits in the First 30 Months of Life
(WCV) – Child and Adolescent Well Care Visits