Certified in Public Health (CPH) Practice Exam

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What is HEDIS primarily used for in health care delivery?

Investigating fraud and abuse violations
Lobbying for employee health investments
Measuring the quality of care provided by HMOs
Providing developmental programming for clinical managers

The correct answer is: Measuring the quality of care provided by HMOs

HEDIS, which stands for Healthcare Effectiveness Data and Information Set, is primarily utilized to measure the quality of care provided by Health Maintenance Organizations (HMOs) and other health plans. It serves as a standardized tool that evaluates various aspects of healthcare delivery, including preventive care, chronic disease management, and patient satisfaction. By using HEDIS measures, healthcare organizations can assess their performance relative to established benchmarks and identify areas needing improvement. This promotes accountability and informed decision-making among providers and stakeholders in the healthcare system. HEDIS metrics thus play a pivotal role in ensuring that health plans maintain high standards of care and contribute to the overall improvement of health outcomes for populations they serve. Other options like investigating fraud and abuse, lobbying for health investments, or providing managerial programming do not align with HEDIS’s primary purpose, which is focused specifically on quality measurement within healthcare settings, thereby affirming the choice related to measuring care quality.