Quality

Quality can be defined as the degree in which providers adhere to pre-established standards based on prevailing knowledge and health care practices. To ensure our providers meet appropriate standards, Healthy Blue participates in many national quality efforts including Healthcare Effectiveness Data and Information Set (HEDIS). The National Committee for Quality Assurance (NCQA) coordinates and administers HEDIS yearly and the Centers for Medicare and Medicaid Services (CMS) uses it for monitoring the performance of health plans.

Quality Resources