Legacy HEDIS® Tools vs. Quality360™: A Feature-by-Feature Breakdown

For years, health plans have relied on traditional HEDIS tools to manage quality measurement and reporting. While these systems helped meet regulatory requirements, they often fall short when it comes to efficiency, data integration, and actionable insights. Now, health plans need more than basic compliance. They need a platform that drives improvement, aligns with value-based care, and helps them outperform in Stars ratings.
 

That’s where we come in. Here’s how our Quality360™ solution compares to legacy HEDIS tools, feature by feature.

Timeliness of Insights

During the regulatory HEDIS season, time is critical. The sooner a health plan receives its data, the more opportunity to optimize performance rates. Quality360 delivers rapid results with a 24-hour turnaround for over 2 million members. Its abstraction feature also connects directly with the engine to update HEDIS rates in real time, giving quality teams more immediate visibility into performance and creating opportunities to act sooner.
 

Measure Calculation and Accuracy

HEDIS specifications evolve frequently, and all certified HEDIS engines must stay current with NCQA updates. Legacy tools often place the burden on health plans to manage version changes, which can add administrative work and risk of errors. With Quality360, updates happen seamlessly in the background, reducing the manual lift for health plans and ensuring accuracy without additional reprocessing cycles.
 

Care Gap Management

Older tools were primarily designed for compliance reporting, not proactive improvement. They provide the numbers but stop short of offering functionality to help close care gaps. Quality360 was built with improvement at its core. This makes it possible not only to measure quality but to actively improve it and drive better outcomes and higher Stars performance. While it is not a direct point-of-care tool, Quality360 makes it easier for health plans to push gap information into provider workflows when desired, supporting proactive engagement.
 

User Experience
 

Rigid interfaces and limited customization are common frustrations with legacy systems. Navigating complex data can feel cumbersome, especially for care teams who need actionable insights. Quality360 flips this experience on its head with an intuitive, user-friendly design. Interactive dashboards and role-based views ensure that each user, from quality teams to providers, gets the information most relevant to them, presented in a way that’s easy to act on.
 

Automation and Efficiency
 

Traditional HEDIS tools still rely heavily on manual effort for data preparation, validation, and submission. This not only increases the risk of errors but also consumes valuable staff time and resources. Quality360 automates the process end to end, from data ingestion through final submission. By reducing the need for manual intervention, health plans can shift focus to member engagement and quality improvement instead of administrative tasks.
 

Scalability and Future-Readiness
 

Legacy systems were built to meet compliance requirements at a point in time, not to support the evolving needs of modern health plans. Expanding into new lines of business or adapting to future regulatory changes can be slow and resource intensive. Quality360 was designed with scalability in mind. Its flexible architecture makes it easy to grow alongside a plan’s business, accommodating new measures, Stars programs, and CMS requirements without the headaches of a disruptive system overhaul.

Why It Matters

For health plans competing in a Stars-driven environment, the difference between legacy tools and Quality360 is more than functionality; it’s about enabling outcomes. Legacy systems may help check the compliance box, but Quality360 is built to support faster insights, more efficient workflows, and better use of data that drives higher Stars ratings, improves member experiences, and reduces administrative burden. Quality360 delivers a modern, data-driven approach that empowers health plans to move from reactive reporting to proactive improvement.