Cotiviti’s HEDIS® measures obtain NCQA Certified Measures ™ status for the measurement year 2021

SALT LAKE CITY – (COMMERCIAL THREAD) – Quality Engine, the administrative measurement logic and systematic sample processing component of Cotiviti’s Quality Intelligence solution, achieved Certified Measures ™ status for the care effectiveness data and information set health (HEDIS®) National Quality Assurance Committee (NCQA) measurement year 2021 (MY 2021). This is the 21st consecutive year that Cotiviti, a leader in data-driven health solutions, has achieved this certification, validating that the measures have successfully passed the rigorous tests required to support health plans with the HEDIS report of This year.

“As payers remain focused on optimizing health outcomes for their members, they need powerful tools that will support this mission during the HEDIS season and throughout the year,” said Emad Rizk, MD, president, president and CEO of Cotiviti. “Receiving NCQA measurement certification for 21 consecutive years demonstrates our strength and reliability in achieving and maintaining this level of validation for more than two decades. Cotiviti has long been committed to helping healthcare plans navigate the healthcare quality landscape and is proud of our continued collaboration with the NCQA.

Cotiviti’s Quality Intelligence solution, comprising Quality Engine and Quality Reporter Web, a very flexible and comprehensive user application, provides a valuable core for effective quality improvement programs, enabling payers to measure and report HEDIS results. The platform allows health plans to track, monitor and improve quality compliance; develop and measure exclusive quality indicators; facilitate HEDIS, Star Ratings and other quality metrics submissions; and implement a year-round measurement and reporting program that significantly improves their ranking.

After a group of early adopter clients were submitted via Quality Reporter Web for AM 2020, Cotiviti clients all migrated to the new interface for AM 2021, achieving increased efficiency and productivity of the flow of work, flexibility and configurability, real-time information and compliance, and integration with medical record retrieval and abstract. In addition to HEDIS, Quality Intelligence has also been certified for California AMP measurements, which are currently reported by 14 California health plans covering approximately 13 million members according to the Integrated Healthcare Association.

“HEDIS is the gold standard when it comes to measuring quality, and Cotiviti is monitoring closely given its importance. When the NCQA revised the certification schedule last year, we reacted quickly to the challenge of certifying measures four months earlier to give our clients a boost in their HEDIS initiatives, ”said RaeAnn Grossman , Executive Vice President, Risk Adjustment, Population Health Management and Quality of Cotiviti. “Quality is an integral part of value-based care, but it must be achieved along with improved payment integrity, risk assessment and member engagement. Our focus on these foundational pillars allows us to develop proven tools that deliver key cost and quality improvements for health plans as well as members. ”

HEDIS is the measurement tool used by healthcare plans across the United States to assess clinical quality and customer service performance, including a standardized set of performance measures that allow buyers and consumers to compare. quality of care between different health plans. Processing data from over 62% of all health plan members for whom HEDIS scores are reported, Quality Intelligence combines NCQA-certified measurement logic and user-friendly reporting software with extraction and retrieval services. disregarding high volume expert medical records to achieve the best results with the least amount of effort health plan every step of the way.

HEDIS® is a registered trademark of NCQA.

HEDIS certified measurementsMT is a registered trademark of NCQA.

NCQA Measures Certification ProgramMT is a registered trademark of NCQA.

About Cotiviti

Cotiviti is a leading solutions and analytics company reshaping the healthcare economy, helping clients discover new opportunities to unlock value. Cotiviti’s solutions are an essential foundation for healthcare payers in their mission to reduce healthcare costs and improve quality through better payment accuracy, quality improvement, risk adjustment, consumer engagement and network performance management programs. Cotiviti’s healthcare solutions are powered by Caspian Clarity, a proprietary data and analytics platform spanning thousands of data types from unique members and vendors across financial and clinical fields, representing the longitudinal dataset. the most comprehensive in the field of health. The company also supports the retail industry with data management and recovery audit services that improve business results. For more information, visit

About NCQA

NCQA is a private, non-profit organization dedicated to improving the quality of healthcare. The NCQA accredits and certifies a wide range of healthcare organizations. It also recognizes clinicians and practices in key areas of performance. The NCQA website has information to help consumers, employers and others make more informed health care choices.

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