HealtheConnections Achieves NCQA Data Aggregator Validation Status

HealtheConnections is among the first in the nation to complete pilot program; Driving efficiencies for providers and health plans for HEDIS® reporting.

HealtheConnections announces that it has completed the NCQA Data Aggregator Validation (DAV) Program Pilot and achieved validation status. The company is among the first approved data aggregators in the country, collaborating with NCQA and two other New York State health information exchanges (HIEs) to develop this program to facilitate the exchange of aggregated clinical data for use in HEDIS® and other quality reporting efforts.

The DAV program’s purpose is to centrally validate data collected by “hubs” – like HIEs – so recipients can use the data as standard supplemental data for HEDIS® reporting without having the data subjected to provider EMR primary source verification by the plan auditor. This designation signals to HealtheConnections’ participating healthcare providers and health plans that, through operational and data quality processes, it can share validated sources for standard supplemental data for use in measurement year 2020 HEDIS® reporting.
“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.”

Payers are not alone when it comes to challenges conducting audits and meeting their reporting requirements. Providers often lack the resources or knowledge to navigate the time-consuming manual effort and inconvenient chart-chasing inherent to current processes.

“The existing methods for data collection to support HEDIS® reporting – and quality measurement in general – are costly and inefficient, and increase the already massive administrative burden for physicians,” said Don Lee, Director of Business Development at HealtheConnections. “By streamlining the exchange of clinical data between validated provider data sources and payers, HealtheConnections can reduce the cost and burden associated with HEDIS® reporting and create new opportunities for mutually beneficial provider/payer collaboration.”
More than 1,500 organizations across 4,000 locations participate with HealtheConnections, representing more than 10,000 licensed physicians. These participants include healthcare providers, community-based organizations, local health departments, and health plans across 26 counties of New York state. Within the HIE are records for nearly 8 million patients, and more coming in each day.

“It’s our responsibility to ensure the completeness and integrity of the data shared within our exchange,” said HealtheConnections President and CEO Rob Hack. “Cornerstone to our operations, we’ve implemented strong customer engagement and data quality processes and standards which are expected by the 500+ participant organizations sharing patient data with us. This NCQA DAV program designation demonstrates the commitment our team has placed on the value and quality of data.”

This designation is an important component of HealtheConnections’ strategic roadmap to leverage the millions of patient health records in the HIE for improved patient care, quality measurement, population health and public health needs.

“[The designation] complements our existing myData analytics platform for provider population health and quality measurement analytics, and our role as a CMS Qualified Registry for MIPS/QPP reporting.” said Lee, referencing the analytics application launched in 2019. myData is HealtheConnections first widely-released application designed to apply HIE data for analytics purposes. Now, more than 100 participants use it to access and understand their patient profiles, identify gaps in care, and see how they rank in MIPS/QPP quality measures.

HealtheConnections’ validation status is effective from October 2020 through October 2021. As 2021 unfolds, HealtheConnections will maintain its focus on practical application of HIE data and data provenance, working with providers and health plans to expand the approved data sources for subsequent HEDIS® reporting years.

About NCQA – NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA’s website contains information to help consumers, employers and others make more informed health care choices. NCQA can be found online at ncqa.org, on Twitter @ncqa, on Facebook at facebook.com/NCQA.org/ and on LinkedIn at linkedin.com/company/ncqa.