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Cotiviti’s Quality Measurement and Reporting Solution Achieves 25th Consecutive Year of HEDIS® Measure Certification

via Business Wire

HEDIS measures embedded in Cotiviti’s Quality Intelligence pass NCQA’s validation process for Measurement Year (MY) 2025

Quality Engine, the administrative measure logic and sample processing component of Cotiviti’s Quality Intelligence solution, has earned HEDIS® Certified Measures™ status from the National Committee for Quality Assurance (NCQA) for Measurement Year (MY) 2025. HEDIS Measure Certification validates that Cotiviti’s measures have been put through the thorough testing required to effectively support health plans with the HEDIS MY 2025 season. This milestone marks an industry-leading 25 consecutive years of certification, demonstrating Cotiviti’s ability to adapt and serve as a long-term partner to health plans as the HEDIS program continually evolves.

“The ongoing transition to fully digital quality measurement requires health plans to have a quality improvement solution that not only meets the highest standards for accuracy, but continually evolves to meet and exceed new requirements,” said Emad Rizk, M.D., chairman, president, and CEO of Cotiviti. “This achievement reflects Cotiviti’s unwavering commitment to supporting our health plan clients. It speaks to the deep expertise we’ve built through decades of working with billions of data points, navigating complex measurement requirements, and helping our clients meet the changing demands of quality reporting.”

Cotiviti’s Quality Intelligence processes more than 147 million member lives reported to NCQA and serves as a comprehensive measurement and reporting solution that streamlines compliance while supporting HEDIS, state-specific, and other quality measure submissions. Newly launched in 2025, Cotiviti’s Engagement Hub integrates with Quality Intelligence to drive coordination and efficiency through a centralized member engagement and reporting platform, enabling plans to close care gaps to ultimately improve quality scores.

Further integrations within Cotiviti’s quality improvement ecosystem support year-round quality improvement and enable better member health. When integrated with Cotiviti’s Star Intelligence, Quality Intelligence provides a centralized platform for managing both HEDIS and Star Ratings, helping clients ensure consistency across programs and maintain compatibility with historical data to support accurate trending and projections. Cotiviti’s scalable medical record retrieval and abstraction services also connect directly with the solution to enable end-to-end support for health plans throughout the HEDIS season.

“Payers need a trusted partner in quality improvement with a longstanding track record of success to help them navigate the digital quality transition and deliver high-performing, reliable solutions that have been continuously refined and supported over decades,” said Chad Kinkead, executive vice president of risk adjustment, quality, and engagement for Cotiviti. “Cotiviti’s Quality Intelligence supports all members and lines of business with end-to-end capabilities for accurate processing, reporting, audits, and submissions, backed by a team of experts who are committed to supporting health plans during and after the transition to digital reporting. Our clients can anticipate further innovation as we integrate Cotiviti’s industry-leading quality improvement, DxCG risk assessment, engagement, and risk adjustment solutions with Edifecs’ leading NLP-enabled coding platform, interoperability capabilities, and AI-enabled value based-payment solutions."

About Cotiviti

Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics that improve the quality and sustainability of healthcare in the United States. Cotiviti’s solutions increase transparency and collaboration between payers and providers while empowering them to reduce medical and administrative costs, enable better health, improve claims payment efficiency, streamline operations, drive interoperability, and advance value-based care. Its customers serve the majority of U.S. healthcare consumers, providing coverage and care for over 300 million members and patients. Additionally, Cotiviti offers data management and recovery audit services to the retail sector to improve business outcomes. For more information, visit www.cotiviti.com.

About NCQA

NCQA is a private, non-profit organization dedicated to improving healthcare quality. NCQA accredits and certifies a wide range of healthcare organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s website contains information to help consumers, employers and others make more informed healthcare choices.

This milestone marks an industry-leading 25 consecutive years of certification, demonstrating Cotiviti’s ability to adapt and serve as a long-term partner to health plans as the HEDIS program continually evolves.

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