Cotiviti’s HEDIS® Measures Earn NCQA Certified Measures™ Status for the 2021 Measurement Year

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Quality Engine, the administrative measure logic and systematic sample processing component of Cotivitis Quality Intelligence solution, has earned Certified Measures status for the Healthcare Effectiveness Data and Information Set (HEDIS) 2021 Measurement Year (MY 2021) from the National Committee for Quality Assurance (NCQA).

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Wednesday, October 6, 2021
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Data Management, Practice Management, Technology, Professional Services, Other Health, Health, General Health, Other Technology, Software, Other Professional Services, Insurance, Caspian, Compliance, Quality assurance, Solution, Economics, Healthcare Effectiveness Data and Information Set, NCQA, Logic, Multimedia, Certification, Data management, Engine, National Committee for Quality Assurance, CEO, Population Health Management, Quality, Risk-adjusted return on capital, Program, Health Star Rating System, Risk, Information set, Risk assessment, HEDIS, Quality engineering, National Committee, Medical device, Risk management, Health insurance, Cotiviti, NCQA, COTIVITI, NCQA
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Summary
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  • Quality Engine, the administrative measure logic and systematic sample processing component of Cotivitis Quality Intelligence solution, has earned Certified Measures status for the Healthcare Effectiveness Data and Information Set (HEDIS) 2021 Measurement Year (MY 2021) from the National Committee for Quality Assurance (NCQA).
  • Cotiviti has long been committed to helping health plans navigate the health quality landscape and is proud of our ongoing collaboration with NCQA.
  • In addition to HEDIS, Quality Intelligence was also certified for California AMP measures, which are currently reported by 14 California health plans covering approximately 13 million members according to the Integrated Healthcare Association.
  • HEDIS is the gold standard in quality measurement, and one that Cotiviti closely monitors given its significance.


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®) 2021 Measurement Year (MY 2021) from the National Committee for Quality Assurance (NCQA). This marks the 21st consecutive year that Cotiviti, a leader in data-driven healthcare solutions, has earned this certification, validating that measures have passed the rigorous testing required to support health plans with this year’s HEDIS reporting.

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(Graphic: Business Wire)

(Graphic: Business Wire)

“As payers remain focused on optimizing health outcomes for their members, they need powerful tools that will support this mission during HEDIS season and year-round,” said Emad Rizk, M.D., chairman, president, and CEO of Cotiviti. “Receiving measure certification from NCQA for 21 years in a row demonstrates our strength and reliability in both obtaining and maintaining this level of validation for more than two decades. Cotiviti has long been committed to helping health plans navigate the health quality landscape and is proud of our ongoing collaboration with NCQA.”

Cotiviti’s Quality Intelligence solution, comprising Quality Engine and Quality Reporter Web, a highly flexible and comprehensive user application, provides a valuable core for effective quality improvement programs, allowing payers to measure and report HEDIS results. The platform 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 significantly improves their rankings.

After a group of early adopter clients submitted via Quality Reporter Web for MY 2020, Cotiviti’s clients have all migrated to the new interface for MY 2021, achieving greater workflow efficiency and productivity, flexibility and configurability, real-time insights and compliance, and integration with medical record retrieval and abstraction. In addition to HEDIS, Quality Intelligence was also certified for California AMP measures, which are currently reported by 14 California health plans covering approximately 13 million members according to the Integrated Healthcare Association.

“HEDIS is the gold standard in quality measurement, and one that Cotiviti closely monitors given its significance. When NCQA revised the certification schedule last year, we moved swiftly to meet the challenge of certifying measures four months earlier to give our clients a jumpstart on their HEDIS initiatives,” said RaeAnn Grossman, executive vice president, risk adjustment, population health management, and quality of Cotiviti. “Quality is integral to value-based care, but it must be achieved in tandem with improved payment integrity, risk assessment, and member engagement. Our focus on these core pillars allows us to develop proven tools that deliver key improvements in cost and quality for health plans as well as members.”

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. Processing data for more than 62 percent of all health plan members for whom HEDIS scores are reported, Quality Intelligence combines NCQA-certified measure logic and user-friendly reporting software with high-volume, expert medical record retrieval and abstraction services to drive the best results with the least amount of health plan effort at every step.

HEDIS® is a registered trademark of NCQA.

HEDIS Certified MeasuresTM is a registered trademark of NCQA.

NCQA Measure Certification ProgramTM is a registered trademark of NCQA.

About Cotiviti

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.

About NCQA

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.

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