Data Aggregator Validation

The NCQA Data Aggregator Validation program evaluates clinical data streams to help ensure that health plans, providers, government organizations and others can trust the accuracy of aggregated clinical data for use in Healthcare Effectiveness Data and Information Set (HEDIS®) reporting and other quality programs.

By validating a data stream with NCQA, you:

• Ensure data accuracy: NCQA’s Data Aggregator Validation program evaluates the ingestion, transformation and output of clinical data to help ensure data integrity.
• Save time: Data from health information exchanges (HIEs) and other data aggregators are increasingly used as supplemental data for HEDIS reporting. Data from data streams validated by NCQA can be used as standard supplemental data in HEDIS reporting, eliminating the need for primary source verification (PSV) during the HEDIS audit process. This saves time and money for aggregators, provider organizations and health plans. Read about how the Data Aggregator Validation program impacts health plans and the HEDIS Compliance Audit.
• Support contracting: Contracting partners are looking for assurances that data they ingest is accurate. A validation from NCQA helps give your contracting partners more peace of mind and makes your data more valuable.

What is the Program Structure?

The Data Aggregator Validation program assesses two sets of standards looking at the ingestion, data management and output of clinical data:

• Process, System and Data standards: Assesses the processes, policies and procedures for ingesting, managing and aggregating data.
• Output Data Integrity standards test and review continuity of care document (CCD) and FHIR output files for primary source verification and adherence to the HL7 C-CDA R2.1 Implementation Guide (CCD IG) or the US Core Implementation Guide STU3 (v3.1.1) (FHIR IG).

NCQA’s Data Aggregator Validation program lasts 22 weeks.

What is a data stream?

NCQA validates one or many clusters of clinical data that are ingested, processed and ultimately output as CCD files that conform to the HL7 C-CDA R2.1 Implementation Guide (CCD IG) or FHIR files that conform to the US Core Implementation Guide STU3 (v3.1.1) (FHIR IG). NCQA evaluates data streams from the point of ingestion through the output of the file, ensuring standards and protocols are met, and that data provided from the original source accurately reflect the data reported for use as standard supplemental data for HEDIS or for other quality programs.

Who is Eligible?

Any data stream that meets the standards of the program can be validated by NCQA.

The validated status is conferred to the data stream. Organizations that are responsible for certain standards as part of the validation will earn a Certified Data Partner status for Data Aggregator Validation and can advertise themselves as supporting the NCQA Data Aggregator Validation program.

There are two ways to get a data stream validated.

• Validate a stream as a sole responsible party: Organizations that perform all functions in the program requirements, including facilitating primary source verification, can act as the a sole responsible party for meeting validating a data stream by meeting all program standards.
• Work with a data partner: The aggregation of data sometimes involves multiple parties. For example, an organization might be responsible for the management of the data and output of the CCD or FHIR file, but not have legal access to the primary source data to support PSV. In these cases, the organization that can facilitate PSV is the responsible party for the data stream, but they can partner with other organizations to validate a data stream.

Find A Data Partner

See a directory of organizations participating in NCQA’s Data Aggregator Validation program.

How Do I Start?

Begin by purchasing the Data Aggregator Validation program manual and reviewing the standards. Organizations must buy the manual for the year that corresponds with the year intended to complete validation. Any organization that is completing a revalidation must purchase the most recent manual.

NCQA is validating data streams through a series of cohorts. The first cohort began in July 2021 and validations will be awarded in the fall. To learn more, contact NCQA to speak to a program expert.