NCQA’s Emerging Data Aggregator Validation (DAV) Targets Interoperability and Could Revolutionize the Value of the HIE for Health Plans

NCQA’s Emerging Data Aggregator Validation (DAV) Targets Interoperability and Could Revolutionize the Value of the HIE for Health Plans

Health data exchange

Using HIE data without the added primary source verification burden is what makes the DAV so attractive.

Did you know one of the leading healthcare quality organizations is evolving their programs to permit better use Health Information Exchanges (HIE) data?

That is how valuable the HIE is.

As we talk about the future of quality and best leveraging technology, there’s a lot to consider – including the role of HIEs. While no one can predict the future, having a close eye on what NCQA is working on can provide insight into what lies ahead. As HIE advocates, we love what we are seeing.

We are excited about many of the new NCQA initiatives but the Data Aggregator Validation (DAV) Program stands out because of the possibility of supporting health plans through reporting burden reduction – a promising alignment to making DAV-validated HIEs a go-to partner for HEDIS® success.

A Completely New Approach

Gaining more real-time, comprehensive data about members’ health remains indispensable to payers. In past blogs we’ve discussed how HIEs can support health plans through measure-specific approaches with Electronic Clinical Data System reporting as well as providing NCQA eCQM certified and Measure Certification for HEDIS® technology.

NCQA’s emerging DAV Program is a completely different way of supporting health plans. The focus is not on measures, but on the data itself. HIEs (and other aggregators) that demonstrate achievement of high data standards may be able to provide validated data to health plans as standard supplemental data– eliminating the burden of primary source verification for each audit they undergo.

While the general release of the DAV Program will not occur until mid-2021, preliminary information indicates that the program will target the quality and accuracy of the input data, as well as the final output data files being exchanged.

The HIE – DAV Value Proposition

What makes the DAV Program attractive is that it addresses the interoperability piece of quality measurement by focusing on the data itself to ease primary source verification burdens for health plans, HIEs, providers and other organizations that hold members’ health data. Historically, HIEs could support health plans with NCQA Electronic Clinical Quality Measures (eCQMs) for standard supplemental data but the relationship was hindered by the inability to share data more comprehensively (only for specific measure elements that were certified) and in the QRDA format that is naive to many health plans. If a HIE wanted to share data outside of certified eCQMs, the health plan and HEDIS auditor, for each product line, would have to perform time and resource intensive primary source verification at the HIE and provider levels – a tremendous burden on all.

One way that HIEs can really live out their mission and demonstrate their unique value is to consider pursuing the DAV Program when it becomes available. You as an HIE have the data and technology that puts you in a position to solve or contribute to burden reduction for numerous stakeholders, ultimately, advancing our industry in a way that it needs to move.

Quality is the way of the future and evolving now will give your HIE the competitive edge.

Renee Towne

About the Author
Renee Towne
VP of Population Health at KPI Ninja, Inc.
Renee provides operational leadership of quality initiatives at KPI Ninja. Towne has a background in occupational therapy, education and experience in operational excellence across a variety of healthcare domains. Based on prior experience as a clinician that drove outcomes patient by patient, she is leaving a larger footprint by improving health care more comprehensively, population by population.

About KPI Ninja
KPI Ninja is a data analytics company that helps healthcare organizations accelerate their quality, safety, and financial goals with a unique combination of software and service. We are differentiated by our signature mix of technology, performance management consulting and healthcare expertise. We don’t merely offer software solutions but work shoulder to shoulder with clients to help them draw on the power of analytics and continuous improvement methodologies to become more efficient. In harmony with our data-centered ethos, we truly believe that our success is strongly co-related with yours.

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