Certified Risk Adjustment Coder (CRC)

Which payer type uses HEDIS measures?

1. A. Medicare

2. B. Medicaid

3. C. Private payers

4. D. A variety of payer types

The correct answer is: D. A variety of payer types

HEDIS, which stands for the Healthcare Effectiveness Data and Information Set, is a widely recognized set of performance measures that focus on various aspects of health care quality. These measures are utilized by a diverse array of payer types, including but not limited to Medicare, Medicaid, and private payers. The reason this answer is correct is that HEDIS measures were developed and are maintained by the National Committee for Quality Assurance (NCQA) and are designed to improve health care quality and encourage standardization so that patients receive appropriate and effective care regardless of their insurance coverage. As such, they are relevant not only to Medicare and Medicaid but also to many private insurance plans that aim to enhance care quality, monitor performance, and meet accountability standards. This broad applicability across multiple types of payers is essential for promoting overall public health initiatives and improving population health outcomes. Therefore, the use of HEDIS measures spans a variety of payer types, reflecting the commitment to standardized quality assessment in health care settings.