Cotiviti Certifies All NCQA Digital HEDIS® Measures for Measurement Year 2025

Advancement enables health plans to support both traditional and digital reporting with validated quality as NCQA transitions toward digital-only measurement

SALT LAKE CITY--(BUSINESS WIRE)--Cotiviti, a leader in enterprise healthcare software and data-driven technology solutions, today announced that its Quality Intelligence solution has achieved Digital HEDIS Certification from the National Committee for Quality Assurance (NCQA) for Measurement Year (MY) 2025. This certification of all available digital quality measures (dQMs) positions Cotiviti as a large-scale quality measurement and reporting vendor that fully supports digital workflows alongside traditional HEDIS reporting as the industry advances toward fully digital measurement by NCQA’s 2030 goal.

“Health plans are working hard to fully transition to digital HEDIS reporting by 2030, but still need the flexibility to report traditional, state, and custom quality measures as they continue to adopt FHIR standards,” said Ric Sinclair, CEO of Cotiviti. “Cotiviti’s quality platform with FHIR ingestion simplifies our customers’ ability to meet traditional and digital reporting requirements—while continuing to scale with an integrated ecosystem of value-added solutions and services for Star Ratings improvement, risk adjustment, and member engagement.”

With a track record of more than 25 years in HEDIS measurement and reporting, Cotiviti’s Quality Intelligence is an industry-leading platform that processes data at scale, supporting more than 129 million member lives reported to NCQA, and delivers advanced analytics, reporting, and insights to help health plans drive consistent quality improvement year-round.

“NCQA is committed to advancing a fully digital approach to quality measurement to improve accuracy, efficiency and comparability across the industry,” said Vik Wadhwani, Chief Product and Transformation Officer of NCQA. “Organizations like Cotiviti that achieve digital measure certification early are helping set the pace for this transformation. Cotiviti’s progress reflects strong momentum—and while there’s more work ahead, that continued commitment will help empower health plans to prepare for the transition to digital‑only reporting and realize a more streamlined, standardized future.”

“Achieving full digital HEDIS certification reinforces Cotiviti’s commitment to helping health plans confidently navigate the transition to digital quality measurement,” said Chad Kinkead, EVP of Health Enablement at Cotiviti. “With our single platform, we have the ability to support all traditional, digital, and state and custom workflows. This enables us to partner with our clients to move forward at their own pace while maintaining accuracy, efficiency, and performance.”

Quality Intelligence empowers health plans throughout the transition to digital measurement, enabling them to:

• Leverage familiar tools to minimize disruption
• Translate existing data intake files to the FHIR data model for measure processing
• Reduce variables with comparative measure analysis during the transition

Quality Intelligence now helps plans increase focus on dQM reporting without requiring an immediate shift away from the data sources in use today. Easing the transition burden while delivering both traditional and digital HEDIS capabilities, Cotiviti is uniquely positioned to support health plans through each stage of NCQA’s digital transformation roadmap, enabling them to maintain current reporting needs while preparing for the future of quality measurement.

About Cotiviti

Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics that improve the quality and sustainability of healthcare in the United States. Cotiviti’s solutions increase transparency and collaboration between payers and providers while empowering them to reduce medical and administrative costs, enable better health, improve claims payment efficiency, streamline operations, drive interoperability, and advance value-based care. Its customers serve the majority of U.S. healthcare consumers, providing coverage and care for over 300 million members and patients. For more information, visit www.cotiviti.com.