By Mark Coetzer – For decades, HEDIS has been the foundation of health plan quality measurement, shaping how organizations benchmark performance, report outcomes, and guide quality improvement across Medicaid, Medicare Advantage, and commercial populations.
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By Ross Martin MD MHA FAMIA & Brian Dwyer – Last month, we had the opportunity to attend the 2025 NCQA Health Innovation Summit in San Diego, California, where the conversations focused on improving healthcare quality, equity, and outcomes through innovation. The theme this year was “Reflect, Connect, Inspire,” which felt appropriate.
By Nathan Elliott – NCQA provides a nationally recognized standard for validating an organization’s ability to collect, aggregate, and standardize healthcare data for quality measurement and reporting, such as Healthcare Effectiveness Data and Information Set (HEDIS). It represents more than 72% of the U.S. population.
By Amit Shah – HEDIS is a measurement set used to determine the efficacy of a payer to care for its members. The performance data collected through HEDIS assists payers in identifying areas for improvement as well as tracking successes through a measurement set that allows them to be compared to other payers.
Civitas 2023 coming up on August 20th. This annual event will bring the top players in healthcare interoperability together to discuss and showcase the leading issues and solutions to our ongoing quest for secure and available health data exchange. See you at the Gaylord!
Moving our healthcare system into the digital age, better outcomes, controlling and reducing costs, and patient access to their health data. Our monthly HIE rundown includes updates on TEFCA, HIE networks, job openings and vendor contracts.
By Joni Orand – For quality professionals, job number one is jump starting healthcare quality initiatives that took a back seat during the height of COVID-19. As hospital staff were stretched thin and supply chains were disrupted CMS even temporarily suspended quality reporting requirements for Medicare quality programs in 2020.
The National Committee for Quality Assurance launched its inaugural Digital Quality Solutions pilot, a software product development project with six trailblazing health plans, delivery systems and health information technology firms.
Latest news being reported on payers and the health insurance industry including news from 1upHealth, NCQA, AHIP, CVS Health, Independence Blue Cross, Anthem, CVS Health, Blue Cross Blue Shield Association, UnitedHealthcare, and more.