Getty Images

California HIE Earns NCQA Validated Data Stream Designation for Third Year

As an NCQA Validated Data Stream, California’s statewide health information exchange (HIE) helps reduce the burden of HEDIS reporting for payers.

Manifest MedEx (MX), California’s statewide health information exchange (HIE), has earned the Validated Data Stream designation in the National Committee for Quality Assurance (NCQA) Data Aggregator Validation program for a third consecutive year.

The HIE shares health data for 34 million Californians across the state. Data streams that earn NCQA Data Aggregator Validation undergo a rigorous examination of data quality, integrity, and security.  

Validated data flows can enhance the efficiency of quality measurement. When health plans report data from Data Aggregator Validation validated sources, they do not need primary source verification for HEDIS reporting.

“This program is critical in saving time spent on chart chases for health plans and providers, as well as improving health outcomes and experience for members and patients,” Erica Galvez, chief executive officer of Manifest MedEx, noted in a press release.

“Not only does it reduce the burden of HEDIS reporting, but by improving data accuracy in gaps in care, health plans and providers are better able to identify and provide the care individuals need—like vaccinations and preventive screenings—while avoiding duplicative tests and treatments, which add to overall healthcare costs,” she added.

HEDIS measures, or Healthcare Effectiveness Data and Information Set measures, help healthcare providers and payers understand their current performance in key areas and plan quality improvement efforts.

Manifest MedEx has provided validated data since Reporting Year 2021, allowing payers like Health Plan of San Joaquin (HPSJ) to optimize HEDIS reporting with validated data and HEDIS data extracts.

The combined NCQA-validated data and extracted data for HEDIS reporting from MX is one of the largest influences on administrative rates outside of HPSJ’s claims data.

In Reporting Year 2022, HPSJ saw a 16.5 percent increase in Comprehensive Diabetes Care (CDC) Hemoglobin A1c (HbA1c) and an 8.2 percent increase in administrative rate for Controlling High Blood Pressure (CBP) vs without data from MX.

Next Steps

Dig Deeper on Interoperability in healthcare