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DIGITAL QUALITY MEASURES
Digital Quality Measures
Get ready for digital HEDIS® without putting your CMS Star Rating at risk.
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Navigate Digital Quality Measures with a Partner You Trust
By 2030, NCQA will require every HEDIS measure to be reported as a digital quality measure (dQM). Most vendors will ask you to cut over to a new engine and validate their work against your live program. We won't. Inovalon is the only dQM readiness path that keeps your current HEDIS submission process running exactly as it does today, while your team tests digital measures in a sandbox alongside it.
Test Digital Without Impacting Your Current Rates
Run NCQA digital measures in a sandbox while your production HEDIS submission runs unchanged. Your current reporting, feeds, and submission path stay in place.
One Contract. One Team to Call.
One solution encompassing dQM engine, ingestion of data formatted to the HL7® FHIR® standard, medical record review, member outreach, and CMS Stars analytics – all delivered by one partner to reduce integration complexity and provide clear, end-to-end accountability.
Experts Who've Sat in Your Seat
Our team includes former health plan quality leaders, HEDIS auditors, and NCQA staff, bringing firsthand experience and expertise that informs every solution we deliver.
Prepare for 2030 Without Disrupting 2026
Identify rate risks early, before they impact your CMS Star Rating, approach audits with confidence in the integrity of your data, and begin operational improvements on a timeline you control.
Your Rates Stay Protected
The real risk in the transition isn’t the engine: it’s the rate drop that can occur when FHIR-formatted clinical data replaces chart-abstracted hybrid data. We help you see what’s coming and manage it before it impacts your submission.
You Start This Year, Not 2029
Keep your existing Inovalon data feeds. We normalize them to align with the FHIR standard so your team can begin comparative testing now, without re-plumbing your source systems or waiting for perfect data.
Your Audit Team Has Answers
See exactly why each member was included, excluded, or flagged, traced back to the source FHIR resource. Every auditor inquiry is met with clear, defensible answers.
25
Years as an NCQA-certified HEDIS® vendor1
70%
Of MA enrollees in 4+ Star plans run on our platform2
#1
Best in KLAS Quality Measurement & Reporting, 20263
HOW IT WORKS
Production Stays Production
Your existing HEDIS workflow keeps running exactly as it does today. Readiness happens in parallel, in a sandbox separate from your production workflow. When you're ready to cut over, you cut over on your timeline, not ours.
- Convert to FHIR-formatted data conversion, no source-system change
- Sandbox test projects to run dQMs in parallel
- NCQA-validated digital measure packages
- Rate variance modeling before you submit
- Expert support, not a ticket queue
- Member-level explainability traced to source FHIR-formatted data
The Dual-Track Architecture
Production Track
Your HEDIS submission, untouched
Existing feeds, NCQA-certified measures, validated IDSS and CMS PLD exports, live submission through 2029.
Running in Parallel
Readiness Track
Testing in a sandbox environment with FHIR-formatted data
Existing feeds converted to align with FHIR standard, NCQA-validated digital measures, voluntary comparative testing 2026 to 2029.
Your production HEDIS submission runs unchanged
EXPERT POINT OF VIEW
Led by People Who Helped Build the Standards
Inovalon's dQM strategy is led by quality leaders who built their careers inside NCQA, with expertise not just in implementing the standards but in writing and validating them.
“The plans that win the dQM transition won’t be the ones who picked the flashiest engine. They’ll be the ones that prepared not only for a DQM engine, but also the retirement of the hybrid methodology and were incrementally planning ahead to treat 2026–2029 as an opportunity for operating model redesign. Protecting current performance while their data, people, and processes evolve toward digital.”
Courtney Breece
VP, Product Management, Converged Quality, Inovalon
Former Assistant Director, NCQA Measure Validation
TESTIMONIALS
Real Results, Real Voices
Discover the Inovalon difference.
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HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
HL7, FHIR and the FHIR [FLAME DESIGN] are the registered trademarks of Health Level Seven International and their use does not constitute endorsement by HL7.
1 “Inovalon’s Converged Quality Achieves 25th Consecutive NCQA HEDIS® Certification,” Inovalon, July 31, 2025, https://www.inovalon.com/news/inovalons-converged-quality-achieves-25th-consecutive-ncqa-hedis-measure-certification/
2 “Inovalon Powers 70% of Medicare Advantage Enrollees in 4+ Star Plans, Continuing to Outperform National Averages in 2026 CMS Star Ratings,” Inovalon, October 30, 2025, https://www.inovalon.com/news/inovalon-powers-70-of-medicare-advantage-enrollees-in-4-star-plans-continuing-to-outperform-national-averages-in-2026-cms-star-ratings/
3 Inovalon, Converged Quality achieves Best in KLAS press release, February 4, 2026.
Resources
dQM Resources
Wherever you are in the transition to dQMS – shortlisting vendors, drafting a plan, or still feeling overwhelmed by the change – we've got you covered.
© 2026 Inovalon.
