Within the past decade, healthcare has shifted toward a pay-for-performance model where health plans now utilize tools such as the Healthcare Effectiveness Data and Information Set (HEDIS) to assess an institution’s performance and patient satisfaction. The focus of this article will be HEDIS’ inclusion of pneumococcal vaccination for older adults.
Designed by the National Committee for Quality Assurance, HEDIS is used by more than 90% of U.S. health plans to measure whether an institution is providing quality patient care. The data obtained through HEDIS are designed specifically to be able to compare performance within a healthcare institution and among different institutions across the country. These data are readily available for all to review and for hospitals to focus on areas that require improvements. With the recent 2018 HEDIS update, seven new dimensions have now been implemented and are considered standards of care: (1) transitions of care; (2) follow-up after emergency department visit for people with high-risk multiple chronic conditions; (3) use of opioids at high dosages; (4) use of opioids from multiple providers; (5) depression screening and follow-up for adolescents and adults; (6) unhealthy alcohol use screening and follow-up; and (7) pneumococcal vaccination coverage for older adults.
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