Astrata Leverages NCQA’s Digital Content Services to Create an Advanced HEDIS® Engine

HIGHLIGHTS

• Astrata and NCQA have aligned to advance digital quality measurement.

• As an early adopter of NCQA’s Digital Content Services, Astrata deepened its expertise in digital measures, enabling the company to create transformative solutions like its eMeasure platform.

• By leveraging NCQA’s digital HEDIS content, Astrata provides a roadmap and tools for health plans to transition to digital quality measurement.

THE CHALLENGE

Health care organizations face a pressing need to transition from traditional quality reporting methods to digital measurement—a goal set by the Centers for Medicare & Medicaid Services and embraced by NCQA. Current processes, such as traditional HEDIS reporting, are being phased out, creating challenges for organizations to modernize their systems while maintaining compliance and data integrity.

THE SOLUTION

NCQA’s Digital Content Services is a software application that provides access to digitalized HEDIS measures. It is installed in a cloud environment, making it simpler for organizations to access, update and integrate NCQA’s digital HEDIS content. Astrata was an early adopter of Digital Content Services, integrating NCQA’s real-time digital measure updates and standardized formats into its FHIR-based HEDIS engine.

Astrata also developed a digital quality maturity model to provide a structured roadmap for health plans to transition to digital quality measurement. This phased approach helps organizations tackle the transformation in manageable steps, ensuring alignment with broader data strategies while enabling faster adoption of digital quality measures with improved accuracy and timeliness.

“NCQA’s Digital Content Services enables seamless delivery of HEDIS measure packages, reducing the need for manual coding and ensuring compatibility with modern clinical data sources. It provides the core content for our eMeasure engine.”

Dr. Rebecca Jacobson, Co-Founder, CEO and President, Astrata

Bringing the Solution to Health Plans

AmeriHealth Caritas—a national managed care organization serving over 5 million members across Medicaid, Medicare and CHIP programs—needed to transition its quality reporting processes to align with new digital standards to remain competitive and improve member outcomes. In early 2023, AmeriHealth Caritas became one of the first organizations to adopt Astrata’s eMeasure system.

The first phase of the implementation focused on mapping clinical data to FHIR resources for a subset of digital measures. AmeriHealth utilized Astrata’s HITRUST-certified, cloud-based eMeasure sandbox, reducing costs associated with maintaining a second HEDIS engine during the transition. Throughout this process, the teams addressed key challenges in FHIR data mapping, data quality and CQL engine implementation.

Astrata’s participation in NCQA’s Digital Content Services Early Adopter Program provided valuable insights to help ensure seamless integration of digital measure packages and improve the accuracy of measure computation.

“As healthcare evolves, so must the tools we use. Investing in digital quality transformation allows us to stay ahead of upcoming regulatory changes while driving meaningful improvements in patient care.”

Joy Bland, DBH, RN, CCM, CPHQ, SVP Quality & Health Equity, AmeriHealth Caritas

RESULTS

AmeriHealth Caritas successfully completed the first phase of Astrata’s maturity model, generating its initial digital HEDIS measure results. The next phase will expand the number of digital measures and benchmark them against traditional HEDIS reporting methods to ensure continued progress.

By adopting digital quality measurement—facilitated by NCQA’s digital HEDIS content and Astrata’s eMeasure engine—health care organizations can gain a more comprehensive view of measure compliance, closer-to-real-time results and insights to inform quality improvement initiatives, enhance member engagement and improve health outcomes.

“NCQA is an enabler of the digital quality transition, providing digital content that organizations can leverage within their own technology stack. As one of the early adopters of DCS, Astrata is at the forefront of innovation, positioning itself for long-term success.”

Amol Vyas, Vice President of Interoperability, NCQA

ABOUT THE COMPANIES

•Astrata, Inc.: A leader in digital quality transformation, Astrata provides FHIR-first solutions, such as eMeasure, to help health plans transition to real-time, accurate quality measurement systems.

•NCQA: A nonprofit organization focused on health care quality improvement, NCQA sets the standards for HEDIS measures and supports the adoption of digital quality solutions through programs like Digital Content Services.