February 7, 2006

Seven Vendors Receive NCQA HEDIS® Software Certification

Health plans using certified vendors’ software are
exempt from source code review during HEDIS 2006 Compliance Audit™

WASHINGTON— The National Committee for Quality Assurance (NCQA) announced today that seven leading commercial software vendors received NCQA Certification for their 2006 Health Plan Employer Data and Information Set (HEDIS®)-related software. Health plans that use NCQA-Certified software for HEDIS data collection are not required to undergo manual source code review during the HEDIS Compliance Audit™, a component of NCQA Accreditation and other oversight programs. Three additional vendors expect to complete testing later this spring.

“Certified Software Vendors help streamline the audit process and allow plans to spend more time improving the quality of care for their members,” said Mary Braman, NCQA Director of Licensure & Certification. “NCQA encourages all organizations that gather and report HEDIS data to consider using a certified HEDIS software vendor when making contracting decisions.”

The following vendors have received NCQA HEDIS® Software Certification:

• Catalyst Technologies, Inc.
• DST Health Solutions
• Emdeon Business Services
• Ingenix, Inc.
• McKesson Health Solutions, LLC
• Q Mark, Inc.
• TierMed Systems, LLC

Three vendors, Austin Provider Solutions, Inc., Founding Medical Informatics and ODIS, LLC are still in testing and will receive their results later this spring.

HEDIS® software is designed to sift through health plan databases, collect relevant data and calculate HEDIS results. NCQA validates software by generating unique sets of sample data, or “test decks,” for vendors to process using their software. NCQA compares the vendors’ output to the expected results to determine if the software computes HEDIS results correctly. The automated process provides for a precise, comprehensive source code review.

Four of the ten vendors are participating in the Limited Software Certification program, which certifies software packages that produce results for partial or custom measurement sets such as those used in the Pay for Performance (P4P) program in California,. Many provider organizations and plans purchase such software to meet specialized data reporting and quality improvement needs. The vendors participating are:

• Austin Provider Solutions
• Catalyst Technologies, Inc.
• Q Mark, Inc.
• TierMed Systems, LLC

For more information about either HEDIS Software CertificationSM program, contact Anne Smith, Manager, Licensure and Certification at (303) 651-6995, or e-mail smith@ncqa.org.

NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and physicians and manages the evolution of HEDIS®, the performance measurement tool used by more than 90 percent of the nation’s health plans. NCQA is committed to providing health care quality information through the Web and the media in order to help consumers, employers and others make more informed health care choices.