Converged Quality is again certified for traditional HEDIS reporting and now validated to support the industry’s transition to digital quality measures expected to shape health plan reporting by 2030

BOWIE, Md.: Inovalon, a leading provider of data and solutions empowering data-driven healthcare, today announced two milestones in health plan quality reporting: its Converged Quality™ solution has achieved NCQA HEDIS® Measure Certification from the National Committee for Quality Assurance (NCQA) for HEDIS Measurement Year 2026 (MY26) for the 26th consecutive year, and NCQA has validated Inovalon’s Converged Quality measure engine for digital quality measures (dQMs). Together, these achievements position Inovalon at the forefront of the industry’s shift to digital quality, aligning with the standards that both NCQA and the Centers for Medicare & Medicaid Services (CMS) are driving toward by 2030.

As federal and state quality programs grow more complex, health plans face mounting pressure to deliver accurate, timely HEDIS submissions that protect Star Ratings and maximize quality incentive payments. At the same time, NCQA and CMS are moving the industry toward digital measure specifications built on a common standard, HL7® FHIR®, the same modern standard powering interoperability across EHRs, labs, and health information exchanges. As a result, more than 100 health plans, including 12 of the top 15 in the United States, trust Converged Quality to stay ahead. These customers rely on Inovalon’s platform to process clinical quality metrics on more than 209 million lives annually, covering over 85% of all HEDIS covered lives nationally.

“Inovalon's longstanding NCQA certification reflects the discipline and rigor required to support quality measurement at scale, year after year,” said Vik Wadhwani, Chief Product & Transformation Officer at NCQA. “Just as important, their validated digital quality measure engine signals the kind of readiness the industry needs as it moves toward digital reporting. We congratulate Inovalon on this milestone and look forward to working together to shape a more interoperable, data-driven future for health care quality.”

Built for real-time analytics, Converged Quality goes beyond core reporting with add-ons for national and regional benchmarking, Star Ratings forecasting, medical record abstraction, analytics for population outcomes, and provider and member engagement. Integrated with Inovalon's Converged Risk™ solution, it also enables health plans to consolidate internal programs and vendors, improving oversight and streamlining operations. Inovalon is one of only three vendors to achieve 100% validation coverage for NCQA's digital quality measures, with alignment with Clinical Quality Language (CQL) and FHIR® standards.

“Strong partnerships are essential to advancing quality healthcare, and our longstanding relationship with Inovalon has been a valuable part of that effort,” said Cynthia Rooney, AVP of Quality & Risk Adjustment at VillageCareMAX, a Managed Care Plan serving New York City, and a few surrounding counties. “Their ability to combine technology, analytics, and industry expertise has helped us make informed decisions that support our members and providers. We are pleased to celebrate this milestone with Inovalon and look forward to working together to address the opportunities and challenges of the future healthcare landscape.”

"Inovalon's primary source data and analytics are what make 26 years of accurate HEDIS reporting possible, and that same foundation is what NCQA validated for digital quality measures," said Ed Chidsey, President of Inovalon's Life Sciences & Payer Business Units. "Health plans working with Inovalon today are positioned for the shift to dQMs with the data, the platform, and the partner they already know."

To learn more about Inovalon’s solutions for quality, risk, and other strategic initiatives, please visit: https://www.inovalon.com/products/payer-cloud/quality/.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA). NCQA Measure Certification Program™ is a trademark of the National Committee for Quality Assurance (NCQA). HL7 and FHIR are the registered trademarks of Health Level Seven International and their use does not constitute endorsement by HL7.

About Inovalon

Inovalon is a leading provider of data and solutions empowering data-driven healthcare. We bring together national-scale connectivity, real-time primary source data access, and advanced analytics into a sophisticated platform empowering improved outcomes and economics across the healthcare ecosystem. The company’s analytics and capabilities are used by over 50,000 active, licensed customers, and are informed by the primary source data of more than 99 billion medical events across 1.1 million physicians, 736,000 clinical settings, and 461 million unique lives. For more information, visit www.inovalon.com.

Fonte: Business Wire