NINE SOFTWARE VENDORS RECEIVE NCQA’S SOFTWARE CERTIFICATIONSM
Health plans using certified vendors’ software exempt from source code review during HEDIS 2007 Compliance Audit™
WASHINGTON—Nine leading software vendors have received certification from the National Committee for Quality Assurance (NCQA) for their Health Plan Employer Data and Information Set (HEDIS®)-related software.
Health plans using 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. The nine certified vendors include:
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Austin Provider Solutions, Inc.
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Catalyst Technologies, Inc.
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DST Health Solutions
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Ingenix, Inc.
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McKesson Health Solutions, LLC
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MedAssurant, Inc.
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Q Mark, Inc.
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TierMed Systems, LLC
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ViPS, Inc.
Vendors pursuing HEDIS Certification are:
HEDIS software sifts through health plan databases to collect relevant data and calculate HEDIS results. NCQA validates software by generating sets of sample data, or "test cases," for vendors to process using their software. NCQA compares vendors’ output to expected results to determine if the software computes HEDIS results correctly.
This year’s HEDIS Software Certification included four performance measures introduced into HEDIS 2007. Among them are Potentially Harmful Drug-Disease Interactions in the Elderly and new three Relative Resource Use (RRU) measures. The RRU measures provide standardized, risk-adjusted assessments of efficiency for care of asthma, diabetes and acute low back pain, allowing for national benchmarking of utilization patterns.
“RRU measures allow purchasers to compare plans on both quality and cost and produce tremendously valuable information. But programming for them is a complex proposition,” said Mary Braman, NCQA Director of Licensure & Certification. “Contracting with an NCQA-Certified software vendor streamlines the audit process, and provides accurate HEDIS results.”
In addition to full certification, NCQA offers limited certification to vendors whose software tests a subset of the HEDIS measurement set. Eight vendors are completing testing for products that support the health plans and provider organizations that produce data for California’s Pay for Performance (P4P) initiative, an effort that uses standardized measures to evaluate the performance of physician organizations and reward those that perform at a high level. Vendors who have passed Limited Software Certification are:
Vendors pursuing Limited Software Certification include:
- Austin Provider Solutions, Inc.
- Innoapp, LLC
- Integration Management, Inc.
- ManagedCare.com
- MedAssurant, Inc.
- TierMed Systems, LLC
NCQA maintains an updated list of vendors that receive full or limited certification on its Web site at www.ncqa.org/HEDIS/softcert.aspx. For more information about either Software CertificationSM program, contact Anne Smith, Manger, Licensure & Certification, at (303) 651-6995 or smith@ncqa.org.
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA is the nation’s leading developer of health care evaluation tools including health plan accreditation, physician recognition and organization certification. NCQA also is responsible for the evolution of HEDIS®, the most widely used set of health care performance measures. NCQA is committed to providing health care quality information through the Web, media and data licensing agreements in order to help consumers, employers and others make more informed health choices. For more information, visit www.ncqa.org.
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HEDIS® is a registered trademark of NCQA.
HEDIS Software CertificationSM is a service mark of NCQA.
HEDIS Compliance AuditTM is a trademark of NCQA. All rights reserved.