Healthcare Effectiveness Data and Information Set RIF

The Healthcare Effectiveness Data and Information Set (HEDIS) file contains beneficiary level records that combine to create measures of managed care plan performance. CMS MA plans provide patient-level data to CMS annually. Data from HEDIS contributes to the assignment of plan CMS Star Ratings.

What does this file include? (variable highlights)

  • Beneficiary level records
  • SNP enrollment
  • Body Mass Index (BMI)
  • Disease screening indicators
  • Chronic condition treatment indicators
  • Counts of specific procedures

Availability of this file

Availability:

Measurement Years 2015-2021

There was no HEDIS data submission requirement in 2020 for MA due to the COVID-19 pandemic.

See what is in this file