How to Implement

Playbook Resources

Based on the workstreams and organization types (see below) and the phased approach to the Digital Quality Transition, NCQA will create playbooks with corresponding resources that make it easy for different stakeholders to focus on what is important and relevant to them and use cases they support.

To get started, look at the diagram below. Typically, each stakeholder (user of the playbooks) will find their place at an intersection of an organization type and a workstream.

Your Implementation By Phases

The following table outlines the major to-dos and goals for each workstream across the phases in the digital quality transition.

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Getting Started

To get a head-start on some of the most prominent topics for the transition to digital quality, here are six areas to consider.

Based on the determination made on the workstream and organization type, some of these may be more important or urgent to certain stakeholders. However, at a high level, a good understanding of all areas essential to approach the digital quality transition for all stakeholders. Check back frequently as resources are updated.

Data Standardization

  • The transformation of proprietary data sources to standard FHIR data models. Learn More.

Execution CQL Engine

  • The engine that processes measures and generates calculated outcomes. Learn More.

Measure Delivery Method

  • How measure specifications are delivered. The measure delivery method will transition from delivery through the HEDIS Volume 2 publication to delivery through NCQA’s Digital Content Services.

Reporting Benchmarking & Submission

  • Benchmarking is trending and comparing HEDIS rates to those of other health plans and geographical locations.
  • Submission is presenting HEDIS measure outcomes for health plan or other reporting contracts.

Data Collection Method

  • How HEDIS data are collected for submission. The digital transition will bring a shift to a more focused ECDS method.

Certification, Logic & Audit

  • Certification is the process of validating measure logic for vendors that process HEDIS measures.