CUSTOMER STORY
Improving HEDIS® Rate Analysis and Performance With Better Data Management
The Need
Faced with inefficiencies in quality analytics data management, access, and scale, a national health plan needed a smarter way to streamline operations and improve HEDIS performance.
The goal? Spend less time on manual processes and more on achieving better rates and delivering actionable insights to stakeholders.
Time To Actionable Data
What does it traditionally take?
Time and resources
- Traditional HEDIS audits demand up to three hours per data export, slowing down actionable insights and creating bottlenecks in decision-making.
- As new catalogs or measurement periods are run, health plans must take the time to manually extract data, organize, and ensure accuracy.
A large investment
- For a 200K-member plan, building a robust data warehouse can cost up to $1.5 million and take 18 months – resources better spent on improving care outcomes.
- Health plans may lack key data sources, like administrative claims and hybrid sample data, forcing them to rely on extra tools or manual effort for meaningful analysis.
The Plan
With Inovalon Healthcare Data Lake, the health plan automated data pipelines to immediately feed data in after each data refresh and analytics run. This included:
Quality and risk analytics:
Clinical quality and risk score accuracy gaps from regulatory and custom catalogs
Medical record management:
Chase and rate details for hybrid measures for their auditor-selected sample populations to compare against administrative rates
Administrative information:
Medical and pharmacy claims, member, member enrollment, and provider data
The Results
Since the health plan was already active on the Inovalon ONE® Platform, the plan received all datasets for querying or connecting in less than two weeks, improving the speed and effectiveness across the organization.
100+
The average number of data extracts completed per month in 2023
<30 minutes
The average time to extract, transform, and load data
5-10%
Reduction in rework from data load failures
Enabling Greater Outcomes for Quality Teams
Store, access, enrich, and analyze your data in one centralized place with Inovalon Healthcare Data Lake. Quality teams can use a single-source-of-truth data “superset” to answer their most complex questions.
With Inovalon Healthcare Data Lake, you can:
12K+ views2 – including measure-specific output, flagged events, rate views for individual rate, or table measures – support quick reference and querying to improve time-to-value for data-driven decisions.
Improve aggregate rates at the level your organization needs rather than the populations required for regulatory submissions.
Analyze crucial metadata with sub-measures on 1K+ measures2 to view applicable lines of business, domains, and categories, and measure rate type.
Access 40+ hybrid-measure QMRM output tables2 that allow you to compare hybrid and administrative rates in a single location.
2. Based on MY2023, state and custom catalogs, actual view counts will correspond to the catalogs the plan runs in each analytics run
Inovalon Healthcare Data Lake: How it Works
Healthcare data isn’t just a byproduct of care – it’s the key to better outcomes. Inovalon Healthcare Data Lake empowers health plans to break silos, integrate and customize large volumes of data, and drive smarter, faster decisions tailored to patient needs.
