Set of standard evaluation measures that gives information about the quality and performance of a health plan such as the quality of care, access, cost, patient satisfaction, membership and use, financial information, management, and other measures to compare managed care plans. Employers, health maintenance organizations, and the National Committee for Quality Assurance developed HEDIS. The Centers for Medicare and Medicaid Services (CMS) collects HEDIS data for Medicare plans.
Insurance Encyclopedia
Health Encounter
Each time a person meets with a health care provider to receive services, is a separate “encounter.”
Health Encounters Per Member Per Year
The total number of encounters per year divided by the total number of members per year.
Health Enrollee
An eligible individual who is enrolled in a health plan – does not include an eligible dependent.
Health Enrolling Unit
The organization (such as an employer) that contracts for participation in a health insurance plan.
Health Enrollment
Used to describe the total number of enrollee in a health plan. It may also be used to refer to the process of enrolling people in a health plan.
Health Enrollment Period
The amount of time an employee has to sign up for a contributory health plan.
Health Examination
The medical examination of an applicant for Health Insurance.
Health Expected Claims
The estimated claims for a person or group for a contract year based usually on actuarial statistics.
Health Expected Morbidity
The expected incidence of sickness or injury within a given group during a given period of time as shown on a morbidity table.