Digital Quality Leaps Forward in Health Information Exchange Pilot

November 10, 2020 · Matt Brock

The National Committee for Quality Assurance (NCQA) is pleased to announce a big step forward to boost digital quality and measurement. This follows the success of its new Data Aggregator Validation program (DAV) pilot project it conducted with the New York State Department of Health, the New York eHealth Collaborative (NYeC), and three of the state’s health information exchanges (HIEs):

All three earned one year of “Validated with Exception” status for their participation in the project. The “Validated with Exception” status signals to the industry that each exchange has the ability to share validated sources for standard supplemental data for use in measurement year 2020 HEDISÒ reporting.

Digital Quality: Independent Pilot Review

NCQA chose consulting firm QMetrics as our lead and evaluator for the pilot program. QMetrics worked closely with NCQA to develop the program health care digital measurement protocols and with each HIE to ensure all Data Aggregator Validation program standards and protocols were met. That includes the primary source verification (PSV) process which reviews and evaluates all primary data sources used in aggregated data outputs.

“Our Data Aggregator Validation program was formed to address what payers were telling us, that HEDIS® audits of clinical data from aggregator vendors could prove too burdensome,” said Rick Moore, NCQA Chief Information Officer. “Now, NCQA can validate an aggregator’s data sources prior to a HEDIS reporting year, and then health plans may use the approved sources as standard supplemental data without requiring more audits at the plan level.”

“DAV streamlines current approaches. It returns needed time and resources to both plans and providers,” added Wendy Talbot, NCQA Assistant Vice President of Measure Collection and Audits. “And we’re still moving closer to the ultimate goal—more data sources, better quality of data, and in a shorter time.”

What now? Pilot Implications

Health plans now have access to an efficient process to collect high quality, comprehensive data for HEDIS measurement. Providers will see significantly curtailed burden. Care will not be disrupted as much to meet data collection requests from health plans. Both plans and providers can use the data created from this process to address other needs. For instance, closing care gaps and improving care delivery.

NCQA plans to conduct an Early Adopter phase prior to a broad rollout of the program in 2021.

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