Successful NCQA Pilot Program Proves Utility of QE Data for HEDIS Reporting

NYeC and three SHIN-NY QEs partnered with the National Committee for Quality Assurance (NQCA) and the New York State Department of Health (NYS DOH) to lead an exciting, first in the nation pilot program to support HEDIS reporting by leveraging health information exchange data.

NCQA has developed a new certification, called Data Aggregator Validation. This program was designed to directly respond to the health plan needs to reduce administrative burdens on providers and plans associated with HEDIS reporting. It employs rigorous protocols to evaluate data received by data aggregators, including health information exchanges, that generate output files for distribution to health plans for use in HEDIS reporting.

Three of the SHIN-NY’s QEs participated in this pilot, all completing it successfully and becoming first in the nation to receive this validation, good for one year, which allows them to share data under this new certification. HEALTHeLINK, Hixny, and HealtheConnections can now share their data from their approved data sources with health plans, as it is considered standard supplemental.

This is an exciting development and proves the utility of health information exchange data, such as data within the SHIN-NY, for use in quality and performance reporting.

Health plans working with these QEs now have access to an efficient process to collect high quality, comprehensive data for HEDIS measurement. Providers will see significantly curtailed burden. Care will not be disrupted as much to meet data collection requests from health plans. Both plans and providers can use the data created from this process to address other needs such as closing care gaps and improving care delivery.

For more general information, you can contact NYeC by emailing Tavia Rauch, Director of Clinical Informatics at, and visit NCQA’s website explaining the program.