HEDIS Tag

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Trusted healthcare data supporting health plan quality measurement

22 Sep Health Plan Quality Is Improving. Trusted Data Helps Make It Measurable.

Posted at 15:11h in Health Payers by Matt Langan 0 Comments
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Top Takeaways • More health plans achieved NCQA’s highest rating in 2026, with 18 plans earning 5 stars compared with 11 last year.• Measuring quality improvement depends on having clinical data that is accurate, complete and usable across increasingly complex healthcare environments.• As quality measurement becomes more digital, health plans need stronger data foundations that can support reporting, analytics and ongoing performance improvement.• NCQA Data Aggregator Validation provides an important framework for establishing confidence in aggregated...

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11 Jun Why Health Plans Are Shifting Focus from Data Exchange to Data Intelligence

Posted at 09:34h in Health Payers by Matt Langan 0 Comments
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Top Takeaways • Health plans are increasingly focused on maximizing the value of existing health IT investments. • Interoperability remains important, but organizations now need data that is trusted, usable, and actionable. • Health plans are moving from experimentation to operationalization as AI becomes embedded into workflows such as risk adjustment, claims, and utilization management. • Provider data quality challenges continue to impact operational efficiency, member experience, and reporting accuracy. • Quality, Stars, HEDIS, CAHPS, risk adjustment, and care management...

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13 May AI Is Moving Beyond Experimentation. MSSP ACOs Need the Data Infrastructure to Keep Up.

Posted at 16:35h in Hospitals and Clinics by Matt Langan 0 Comments
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Top Takeaways • AI is moving from experimental to operational across MSSP ACOs as organizations increasingly embed AI into clinical, quality, and care management workflows.• Real-time data infrastructure is becoming essential as ACOs shift from retrospective reporting toward continuous performance monitoring and operational decision making.• Fragmented and delayed data remains a major barrier to scalable AI adoption and value-based care success.• MSSP APP reporting is accelerating the need for trusted data as ACOs move toward full...

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