What is a HEDIS® Engine and Why Do Health Plans Need One?

Achieving high HEDIS performance requires more than just data collection; it demands accuracy, efficiency, and automation. A HEDIS Engine is a powerful software solution designed to streamline the reporting and management of HEDIS measures, helping health plans optimize quality performance and maintain compliance with regulatory standards.

A HEDIS Engine is an advanced analytics platform that automates the collection, calculation, and submission of HEDIS measures. It integrates data from multiple sources, including:

• Claims Data
  Billing and treatment records for performance evaluation

• Electronic Health Records (EHRs)
  Provider-reported data for clinical quality insights

• Patient Surveys
  Direct feedback to enhance care measurement

• Administrative Supplemental Data
  Data from other sources that may contain information about a member’s health care
   

By automating these processes, a HEDIS Engine reduces manual effort, improves data accuracy, and enhances operational efficiency.

Why Do Health Plans Need a HEDIS Engine?

• Improved Accuracy
  Automates data validation to minimize errors in reporting

• Regulatory Compliance
  Ensures adherence to NCQA and CMS quality measurement requirements

• Operational Efficiency
  Reduces the manual workload for quality reporting teams

• Gap Identification and Closure
  Helps detect and address care deficiencies to improve patient outcomes

• Better Financial Performance
  Higher HEDIS scores can lead to increased reimbursement rates and incentives

How UST HealthProof’s Quality360™ Supports HEDIS Optimization

Our NCQA-Certified HEDIS Engine helps to:

• Streamline HEDIS Reporting
  Automating data aggregation and measure calculations

• Enhance Quality Performance
  Providing actionable insights to close care gaps

• Ensure Compliance
  Keeping up with evolving NCQA and CMS standards

By using a HEDIS Engine, health plans can enhance their quality performance, increase efficiency, and achieve better patient outcomes. Contact UST HealthProof today to learn how automation can transform your HEDIS strategy.