What does the term "eligible population" specifically refer to in HEDIS?

The term "eligible population" in HEDIS refers to all members meeting specific criteria outlined in the measures being assessed. This population is crucial because it defines the group of individuals for whom quality measures are calculated, ensuring that the data reflects performance on a wide range of health care services.

For example, a specific HEDIS measure may target adults aged 18-64 who are members of a particular health plan and have a diagnosis of hypertension. The eligible population would then consist of all members who fit these criteria, allowing for meaningful evaluation and comparison of healthcare quality performance across organizations.

This broad inclusion is vital for gaining insights into the quality of care and outcomes within the specified population, ultimately driving improvements in healthcare services.