Question

Healthcare Effectiveness Data and Information Set (HEDIS) is a tool used by most ____ and PPO plans to measure performance on important dimensions of care and service.

a) Medicare
b) Medicaid
c) HMO
d) Insurance

Answer 1

The Healthcare Effectiveness Data and Information Set (HEDIS) is primarily used by health maintenance organizations (HMOs) to measure their performance in providing healthcare services.

Step-by-step explanation:

The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool used by most health maintenance organizations (HMOs) and PPO plans to measure performance on important dimensions of care and service. HMOs provide healthcare that receives a fixed amount per person enrolled in the plan, which is a shift from the traditional fee-for-service basis that was more common in the past. This system intends to reduce the moral hazard by incentivizing providers to offer efficient care while managing the resources among patients.