HEDIS® Accelerator Data Solution

abacus insights hedis digital

Achieve year-round visibility into HEDIS performance and prepare for digital quality measures with usable,
insights-ready data.

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Abacus’ HEDIS Accelerator data solution helps health plans execute year-round continuous quality improvement with a data first approach that starts with automated mapping and configuration of your data to your NCQA certified vendor specifications. Post processed HEDIS data is enriched to facilitate targeted quality improvement for all business use cases, including Medicare Stars and Value Based Contract reconciliation.

Rising Regulatory Demands Call for Smarter, Data-Driven HEDIS Strategies

Expanding Regulatory Pressure

NCQA and CMS are accelerating the shift to digital quality measures (dQMs), requiring FHIR-based, interoperable data.

Operational Inefficiencies

Manual mapping and frequent spec changes strain IT teams, creating rework and delays in interventions.

Missed Opportunities

Limited year-round visibility into performance delays outreach and impacts Stars, Medicaid, Accreditation, and member outcomes.

Implementation Complexity

Limited expertise and resource constraints increase administrative burden and hinder preparedness for year-round HEDIS runs.

Data Shouldn’t be a Barrier for Year-Round HEDIS Effectiveness

Eliminates manual file prep by mapping all health plan data sources, including clinical data feeds, to NCQA-certified vendor specifications or your internal HEDIS engine requirements

Optimize HEDIS operations and planning with configured, file extracts for year-round HEDIS runs that support evolving regulatory, prospective, and retrospective measurement needs

Proactively identify and resolve data discrepancies to reduce audit risk and rework with comprehensive audit support that includes data lineage tracking, NCQA aligned diagrams and documentation, and robust data quality reporting

Access reliable, timely, and usable data transformed post-HEDIS vendor processing to enable continuous care-gap closure, targeted outreach, and sustained member engagement—all readily available for analytics and operations

Access HEDIS measure result in your preferred formats to serve downstream users through BI tools, APIs, real-time streams, advanced analytics, or GenAI platforms
Key Milestones in the Digital Transition

Key Milestones in the Digital Transition

The Future of HEDIS is Digital

Health plans that start preparing for the shift to digital quality measures (dQMs) today will be better prepared for the NCQA mandated shift in 2030:

  • Reducing manual chart reviews
  • Improved accuracy and timeliness of quality reporting
  • Scalable, automated compliance with HEDIS and regulatory requirements
Read our blog…
abacus interoperability milestones hedis accelerator

Modular, Scalable Design for Health Plans of All Sizes

The evolution from manual to digital quality measurement represents more than a compliance requirement. It is an opportunity to fundamentally improve how health plans understand and enhance member care. Organizations that embrace this transformation early will gain competitive advantages in operational efficiency, clinical insights, and member outcomes

Frequently Asked Questions

We already work with an NCQA vendor. How does Abacus fit in?

Abacus automates mapping and reduces maintenance effort while accelerating HEDIS vendor processed file use

How do you help reduce manual data wrangling?

Our prebuilt mappings expedite implementation and free up teams for higher-value work

Can you help us get ready for dQMs?

Our FHIR-ready data foundation streamlines digital-first reporting, minimizing conversion and rework

How flexible is your Solution?

Flexibility is built in. Run in Abacus’ environment or your own

Is your solution secure?

We are HITRUST and SOC 2 certified for five years running, meeting rigorous payer compliance requirements

Our Data Solutions

We focus on data solutions that power payer operations and initiatives

CMS Interoperability Compliance

Enables compliance with the Centers for Medicare and Medicaid Services’ requirements for interoperability for patient access

Risk Adjustment Performance

Unifies and delivers timely data for effective risk adjustment of government-sponsored plans to optimize care for high-needs members

Clinical Data

Integrates clinical, administrative, and health equity data into longitudinal member and patient records to provide a holistic view of the care journey

Total Cost of Care Management

Supports performance measurement and scaling of complex value-based and fee-for-service arrangements by providing current, complete, and accurate data

Stars Performance

Delivers insights-ready™ data for accelerating the best interventions for improving quality, outcomes and Star Ratings