Healthcare Effectiveness Data and Information Set (HEDIS) File 1: Measures File (does not include Plan All-Cause Readmission measure)

The HEDIS Measures file is a person-level file that includes information about all HEDIS measures, except the Plan All-Cause Readmission measure, which is included in HEDIS File 2. It represents beneficiaries enrolled in each MA plan/contract during the year. The file contains indicator variables for whether the beneficiary met the denominator and numerator requirements for each of the HEDIS measures, as well as weights for some measures.

What does this file include? (variable highlights)

  • Colorectal cancer screening
  • Comprehensive diabetes care (multiple measures)
  • High risk medication usage

Each record represents the experience of a beneficiary in a specific plan for the calendar year (CY). Beneficiaries enrolled in more than one plan during the CY will have multiple records in this file.

Beneficiaries can be linked to other beneficiary data via the BENE_ID and to plan information via the HEDIS_CONTRACT_ID and HEDIS_PLAN_ID variables.

Availability of this file

MY 2015-2020*

*There was no HEDIS data submission requirement for the 2019 measurement year due to the COVID-19 pandemic.

The contents of the data vary by measurement year and source of data. CMS records can change annually. CCW is the data source.

See what is in this file