Cotiviti Achieves 20 Consecutive Years of Rigorous NCQA HEDIS® Certification

Quality Intelligence solution earns NCQA Certified MeasuresTM Status for the HEDIS MY 2020 Season


SALT LAKE CITY, February 9, 2021 – Quality Engine, the administrative measure logic and systematic sample processing component of Cotiviti’s Quality Intelligence solution, has earned Healthcare Effectiveness Data and Information Set (HEDIS®) Certified MeasuresTM status from the National Committee for Quality Assurance (NCQA). This marks the 20th consecutive year that Cotiviti, a leader in data-driven healthcare solutions, has earned this certification. NCQA certification validates that measure logic has been put through the thorough testing required to effectively support health plans with the HEDIS Measurement Year 2020 (MY 2020) reporting season.

“In selecting which quality reporting and improvement tools to use, health plans must have full confidence that the solution they select not only meets NCQA’s rigorous standards, but is backed by expertise and a commitment to providing the best possible customer support,” said Emad Rizk, M.D., Cotiviti chairman, president, and chief executive officer. “By achieving measure certification from NCQA for 20 consecutive years and keeping our measure recertifications to a minimum, Cotiviti has demonstrated that payers can have the utmost confidence that our solutions will enable them to meet their quality improvement goals, both during HEDIS season and throughout the year.”

Cotiviti’s achievement of this certification follows the introduction of the company’s Quality Reporter Web solution in mid-2020, a powerful update to Quality Intelligence offering clients greater efficiency and productivity, flexibility and configurability, real-time insights and compliance, and integration with Cotiviti’s medical record retrieval and abstraction services. Quality Reporter Web creates efficiencies for health plans to save time during the HEDIS® season and as they execute downstream reporting initiatives such as identifying gaps in care.

“Our successful development and launch of Quality Reporter Web was driven by our clients’ need for a more flexible, streamlined, and consolidated quality reporting solution,” said Rachael Jones, Cotiviti senior vice president of performance analytics and quality. “By recognizing that quality team members each have unique needs, from reporting analysts to abstraction managers to quality improvement directors, Cotiviti has built a solution that dramatically improves performance for all quality improvement stakeholders.”

HEDIS is the measurement tool used by the nation’s health plans to evaluate their performance in terms of clinical quality and customer service, offering a standardized set of performance measures designed to ensure that purchasers and consumers have the information they need to reliably compare the healthcare quality of various health plans. Processing data for more than 117 million health plan members, Quality Intelligence combines NCQA-certified measure logic and easy-to-use reporting software with high-volume, expert medical record retrieval and abstraction services to drive the best results with the least amount of health plan effort at every step.

Enabling payers to measure and report HEDIS and HEDIS-related metrics with flexibility and insight, Quality Intelligence forms the solid foundation of an effective quality improvement program. Health plans can track, monitor, and improve quality compliance; develop and measure proprietary quality metrics; facilitate HEDIS, Star Ratings, and other quality measure submissions; and implement a year-round measurement and reporting program that significantly improves their ratings and supports their value-based reimbursement initiatives.

HEDIS® is a registered trademark of NCQA.
HEDIS Certified MeasuresTM is a registered trademark of NCQA.
NCQA Measure Certification ProgramTM is a registered trademark of NCQA.

About Cotiviti
Cotiviti is a leading solutions and analytics company that is reshaping the economics of healthcare, helping its clients uncover new opportunities to unlock value. Cotiviti’s solutions are a critical foundation for healthcare payers in their mission to lower healthcare costs and improve quality through higher performing payment accuracy, quality improvement, risk adjustment, and network performance management programs. Cotiviti’s healthcare solutions are powered by Caspian Clarity, a proprietary data and analytics platform spanning thousands of unique member and provider data types across financial and clinical domains, representing the most comprehensive longitudinal data set in healthcare. The company also supports the retail industry with data management and recovery audit services that improve business outcomes. For more information, visit

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.

Media Contact
Kara McCrudden
Aria Marketing for Cotiviti
(401) 474-3308