SALT LAKE CITY--(BUSINESS WIRE)--Quality Engine, the administrative measure logic and systematic sample processing component of Cotiviti’s Quality Intelligence solution, has earned Certified Measures status for the Healthcare Effectiveness Data and Information Set (HEDIS®) 2022 Measurement Year (MY 2022) from the National Committee for Quality Assurance (NCQA). This marks the 22nd consecutive year that Cotiviti, a leader in data-driven healthcare solutions, has earned this certification, validating that Cotiviti’s HEDIS measure logic has passed the rigorous testing required to support health plans for HEDIS MY 2022.
“Quality measurement and improvement is one of the most demanding activities for health plans, requiring rigorously tested solutions that can improve operational efficiency not just during the HEDIS season, but throughout the entire year,” said Emad Rizk, M.D., chairman, president, and CEO of Cotiviti. “By receiving Measure Certification from NCQA for 22 consecutive years and processing data for more than 61 percent of all health plan members for whom HEDIS scores are reported, Cotiviti has established itself as the market leader in quality improvement and a dependable partner that health plans of all sizes can rely on to deliver better outcomes.”
Cotiviti’s Quality Intelligence solution enables health plans to track, monitor, and improve quality compliance; develop and measure proprietary quality metrics; facilitate HEDIS, Star Ratings, and other quality measure submissions; and implement a year-round measurement and reporting program that often significantly improves rankings. For MY 2021, all Cotiviti clients successfully submitted measure results to NCQA using Quality Reporter Web, the highly flexible and comprehensive user interface for Quality Intelligence. This interface delivers greater workflow efficiency and productivity, flexibility and configurability, real-time insights and compliance, and integration with medical record retrieval and abstraction workflows.
For MY 2022, Cotiviti clients will have access to new provider reporting capabilities enabling them to analyze which providers and provider groups are performing at a high level against HEDIS measures, benchmark thresholds, and Star Ratings cut points. Health plans will also be able to generate configurable provider scorecards to distribute performance summaries and insight into member-level care gaps to provider offices, helping ensure their networks are achieving performance benchmarks.
“As NCQA continues to optimize HEDIS measures to improve quality of care and health equity for all member populations, plans need solutions that can continuously adapt to these evolving requirements,” said RaeAnn Grossman, executive vice president of population health management, risk adjustment, and quality operations for Cotiviti. “By continually delivering new enhancements to Quality Intelligence that improve operational efficiency, Cotiviti has demonstrated its commitment to empowering health plans to achieve better quality outcomes with lower resource burden, which enables them to drive tangible improvements to their members’ care.”
HEDIS is the measurement tool used by health plans across the United States to gauge clinical quality and customer service performance, including a standardized set of performance measures that allow purchasers and consumers to compare care quality across various health plans. Quality Intelligence combines NCQA-certified measure logic and user-friendly reporting software with high-volume, expert medical record retrieval and abstraction services to drive optimal results with the least amount of health plan effort at every step.
HEDIS® is a registered trademark of NCQA.
NCQA Measure Certification ProgramTM is a registered trademark of NCQA.
Cotiviti is a leading solutions and analytics company that is reshaping the economics of healthcare, helping its clients uncover new opportunities to unlock value. Cotiviti’s solutions are a critical foundation for healthcare payers in their mission to lower healthcare costs and improve quality through higher performing payment accuracy, quality improvement, risk adjustment, consumer engagement, and network performance management programs. Cotiviti’s healthcare solutions are powered by Caspian Clarity, a proprietary data and analytics platform spanning thousands of unique member and provider data types across financial and clinical domains, representing the most comprehensive longitudinal data set in healthcare. The company also supports the retail industry with data management and recovery audit services that improve business outcomes. For more information, visit www.cotiviti.com.
NCQA is a private, non-profit organization dedicated to improving healthcare quality. NCQA accredits and certifies a wide range of healthcare organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s website contains information to help consumers, employers and others make more informed healthcare choices.